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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''.
__NOTOC__
 
{{Infobox_Disease
{{Infobox_Disease
  | Name          = {{PAGENAME}}
  | Name          = {{PAGENAME}}
  | Image          = Thymoma gross.jpg
  | Image          = Thymoma gross.jpg
  | Caption        = Thymoma: A bottle-shaped tumor is encapsulated and shows a bulging, rather homogeneous, faintly lobulated ivory-colored cut surface. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>
  | Caption        = Thymoma: A bottle-shaped tumor is encapsulated and shows a bulging, rather homogeneous, faintly lobulated ivory-colored cut surface. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>
| DiseasesDB    = 13067
| ICD10          = C37.9, D60
| ICD9          = {{ICD9|164.0}}, {{ICD9|212.6}}
| ICDO          = 8580
| OMIM          =
| MedlinePlus    = 001086
| MeshID        = D013945
}}
}}
{{Thymoma}}
{{Thymoma}}
{{CMG}}
{{Seealso|Thymic carcinoma}}
{{MJM}}
 
__NOTOC__
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''.
 
{{CMG}}; {{MJM}}; {{AM}} {{Sab}}
 
{{SK}} Thymoma; Invasive thymoma; Thymic epithelial tumor
==[[Thymoma overview|Overview]]==


{{Editor Join}}
==[[Thymoma historical perspective|Historical Perspective]]==


==Overview==
==[[Thymoma pathophysiology|Pathophysiology]]==
In [[medicine]] ([[oncology]]), '''thymoma''' is a [[tumor]] originating from the [[thymus]].  It consists of any type of thymic [[epithelial cell]] as well as [[lymphocyte]]s that are usually abundant and probably not [[neoplastic]].  Thymoma usually is [[benign]], and frequently encapsulated;  when occasionally [[malignant]], then it is [[invasive]]:  [[metastasis]] is extremely rare.  Malignant [[lymphomas]] that involve the thymus, e.g., [[lymphosarcoma]], [[Hodgkin's disease]] (termed "granulomatous thymoma" in the past), should not be regarded as thymoma. Thymoma is a [[rare disease]], best known for its enigmatic association with the neuromuscular disorder [[myasthenia gravis]].<ref name=Thomas1999>{{cite journal |author=Thomas CR, Wright CD, Loehrer PJ |title=Thymoma: state of the art |journal=J. Clin. Oncol. |volume=17 |issue=7 |pages=2280–9 |year=1999 |pmid=10561285 |doi=}}</ref>


==Signs and symptoms==
==[[Thymoma causes|Causes]]==
A third of all people with a thymoma have symptoms due to compression of the surrounding organs by an expansive mass. This may take the form of [[vena cava superior syndrome]] (compression of the [[vena cava superior|upper caval vein]]), [[dysphagia]] (difficulty swallowing), [[cough]] or [[chest pain]].<ref name=Thomas1999/>


A third have a thymoma detected because they have an associated [[autoimmune disorder]]. The most common condition in this group is [[myasthenia gravis]] (of which 25-50% are associated with a thymoma); patients with myasthenia are routinely screened for thymoma. Other associated autoimmune conditions are [[pure red cell aplasia]] and Good's syndrome (thymoma with [[combined immunodeficiency]] and hypoimmunoglobulinemia G). Rare associations that have been reported are: [[acute pericarditis]], [[Addison's disease]], [[agranulocytosis]], [[alopecia areata]], [[ulcerative colitis]], [[Cushing's disease]], [[hemolytic anemia]], limbic encephalopathy, [[myocarditis]], [[nephrotic syndrome]], [[panhypopituitarism]], [[pernicious anemia]], [[polymyositis]], [[rheumatoid arthritis]], [[sarcoidosis]], [[scleroderma]], sensorimotor radiculopathy, ''[[stiff person syndrome]]'', [[systemic lupus erythematosus]] and [[thyroiditis]].<ref name=Thomas1999/>
==[[Thymoma differential diagnosis|Differentiating Thymoma from other Diseases]]==


A third to half of all people with a thymoma have no symptoms at all, and the mass is identified on a [[chest X-ray]] performed for an unrelated problem.<ref name=Thomas1999/>
==[[Thymoma epidemiology and demographics|Epidemiology and Demographics]]==


==Diagnosis==
==[[Thymoma risk factors|Risk Factors]]==
When a thymic mass is identified, the made is achieved with [[histology]] (obtaining a tissue sample of the mass). When a thymoma is suspected, a [[Computed axial tomography|CT/CAT scan]] is generally performed to estimate the size of the tumor, and can be [[biopsy|biopsied]] with a CT-guided needle. There is a small risk of [[pneumomediastinum]], [[mediastinitis]] and the risk of damaging the [[heart]] or large blood vessels. The final diagnosis is made by removing the thymus. [[Anatomical pathology|Pathological]] investigation of the specimen will reveal if the tumor was benign or malignant, although the initial biopsy is usually indicative.<ref name=Thomas1999/>


The tumor is generally located inside the thymus, and can be calcified. Increased vascular enhancement can be indicative of malignancy, as can be pleural deposits.<ref name=Thomas1999/>
==[[Thymoma screening|Screening]]==


If the suspicion is high, some [[blood test]]s are often performed to look for associated problems or possible spread. These include: [[full blood count]], [[protein electrophoresis]], [[antibodies]] to the [[acetylcholine receptor]] (indicative of myasthenia), [[electrolyte]]s, [[liver enzyme]]s and [[renal function]].<ref name=Thomas1999/>
==[[Thymoma natural history|Natural History, Complications and Prognosis]]==


<div align="center">
==Diagnosis==
<gallery heights="175" widths="175">
Image:Thymoma-001.jpg|CT shows [[Thymoma]] <small>(Image courtesy of RadsWiki and copylefted)</small>
</gallery>
</div>


==Pathophysiology==
[[Thymoma diagnostic study of choice|Diagnostic Study of Choice]] | [[Thymoma history and symptoms|History and Symptoms ]] | [[ Thymoma physical examination|Physical Examination]] | [[ Thymoma staging|Staging]] | [[Thymoma laboratory tests|Laboratory Findings]] | [[Thymoma electrocardiogram|Electrocardiogram]] | [[Thymoma chest x ray|Chest X Ray]] | [[Thymoma CT|CT]] | [[Thymoma MRI|MRI]] | [[Thymoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Thymoma other imaging findings|Other Imaging Findings]] | [[Thymoma other diagnostic studies|Other Diagnostic Studies]]
Thymoma originates from the [[epithelium|epithelial]] cell population in the thymus. Many subtypes are recognized, some of which have a better- or worse-than-general prognosis.<ref name=Thomas1999/>


==Treatment==
==[[Thymoma treatment|Treatment]]==
Surgery is the mainstay of treatment. If the tumor was benign and was removed completely, no further therapy is necessary. Removal of the thymus in adults does not appear to induce a severe [[immune deficiency]]. In children, however, added care and scrupulous vaccination are necessary to protect from infections. Malignant tumors may need additional treatment with [[radiotherapy]], or sometimes with chemotherapy ([[cyclophosphamide]], [[doxorubicin]] and [[cisplatin]]).<ref name=Thomas1999/>


==Prognosis==
[[Thymoma medical therapy|Medical Therapy]] | [[Thymoma surgery |Surgery]] | [[Thymoma radiotherapy |Radiotherapy]] | [[Thymoma Primary Prevention|Primary Prevention]] | [[Thymoma Secondary Prevention|Secondary Prevention]] | [[Thymoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[Thymoma future or investigational therapies|Future or Investigational Therapies]]
Thymomas associated with autoimmune disorders usually are benign. Malignant thymomas can [[metastasis|metastasize]], generally to [[pleura]], [[kidney]], [[bone]], [[liver]] or [[brain]].<ref name=Thomas1999/>


==Epidemiology==
==Case Studies==
Men and women are equally affected. The typical age at diagnosis is 30-40, although cases have been described in every age group.<ref name=Thomas1999/>


==See also==
[[Thymoma case study one|Case #1]]
*[[Mediastinal tumor]]


==References==
==Related Chapters==
<references/>


==External links==
*[[Mediastinal tumor]]
* [http://www.thymoma.org A large resource about thymoma]


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Latest revision as of 19:02, 3 September 2019

Thymoma
Thymoma: A bottle-shaped tumor is encapsulated and shows a bulging, rather homogeneous, faintly lobulated ivory-colored cut surface.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Thymoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Michael Maddaleni, B.S.; Amr Marawan, M.D. [2] Sabawoon Mirwais, M.B.B.S, M.D.[3]

Synonyms and keywords: Thymoma; Invasive thymoma; Thymic epithelial tumor

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Thymoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Staging | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Radiotherapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

Template:Epithelial neoplasms

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