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A case of type B3 thymoma mimicking primary bone tumor
( Hyeonsik Yoon ),( Younak Choi ),( Tae-jung Jang ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Introduction: Thymomas are rare tumors with an annual incidence of less than 5 per million. The World Health Organization classification of thymoma is based on the morphology dividing thymomas into five groups(type A, AB, B1, B2, and B3). Herein, we report a male with a type B3 thymoma mimicking primary bone tumor. Case: An 81-year-old man found an abruptly protruding 7 × 6 cm sized mass in his left manubrium for two weeks. He did not have any associated symptom.He had a history of tobacco use but had stopped smoking 20 years earlier. Radiologic finding: A computed tomography scan and magnetic resonance imaging revealed a 5.6 × 7.2 × 12.1 cm sized mass lesion bursting symmetrically onto the front and rear direction from the manubrium. The lesion invaded anterior chest wall, mediastinum and apical lung accompanying an enlarged left para aortic lymph node (Fig. 1A). Pathologic finding: Percutaneous needle biopsy was performed. H & E staining revealed the perivascular and intratumoral lymphoid arrangement and hyperchromatic tumor cells with prominent nucleoli. Neoplastic cells are diffusely positive for pancytokeratin and p63 with especially strong positive for cytokeratin 5/6 and negative for CD5 (Fig. 1B). From thesefeatures, we diagnosed this tumor as a type B3 thymoma. Discussions: Type B3 thymoma is also known as epithelial thymoma, squamoid thymoma, and well-differentiated thymic carcinoma. We report this case reminding that thymoma is the most common neoplasm in the anterior mediastinum accounting for 40% of all mediastinal tumors in adults.
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