Anaplastic thymic carcinoma: a clinicopathologic and immunohistochemical study of 6 cases

Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
Human pathology (Impact Factor: 2.77). 11/2011; 43(6):874-7. DOI: 10.1016/j.humpath.2011.07.015
Source: PubMed


Primary thymic anaplastic ("undifferentiated") carcinoma is an unusual thymic neoplasm that, to date, has not been properly characterized. We present 6 such cases in an attempt to better define this entity. The patients were 5 women and 1 man with an age range from 42 to 72 years (mean, 62 years). None of the patients had any history or radiologic evidence of tumor elsewhere. All patients presented with symptoms related to their anterior mediastinal masses: shortness of breath, chest pain, and cough. Histologically, the lesions were characterized by infiltrative tumors with marked cytologic atypia, bizarre tumor giant cells, and atypical mitoses. None of the neoplasms showed areas of other well-defined types of thymic carcinoma. Immunohistochemically, all tumors showed positive staining for pancytokeratin, 40% expressed Pax8, and none reacted with thyroid transcription factor 1 or β-human chorionic gonadotropin. Follow-up available for 4 patients showed that 3 patients had died 14, 22, and 63 months after diagnosis, whereas 1 patient is alive 4 months after diagnosis. Two patients were lost to follow-up. Anaplastic thymic carcinoma is a distinct morphological type of thymic carcinoma with an aggressive clinical course, which needs to be included in the differential diagnosis of tumors displaying giant cells in the anterior mediastinum.

5 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: The clinicopathologic and immunohistochemical features of 65 primary thymic carcinomas are reported (43 men and 22 women; 19-81 years old). Thymectomy was performed in all cases. Masaoka staging for 53 patients showed 3 patients in stage I, 14 in stage II, 17 in stage III, and 19 in stage IV. Histologic studies revealed 9 carcinoma subtypes. Immunohistochemically, the tumors showed high rates of expression for cytokeratin, Pax8, and FoxN1. Follow-up for 62 patients revealed that 36 patients were alive (mean follow-up, 51.1 months) and 26 had died (mean survival, 47.5 months). The 3- and 5-year overall survival rates were 76.6% and 65.7%, respectively. Our findings suggest that thymic carcinomas may behave less aggressively than commonly believed. Lymph node status and tumor size seem to be important prognostic factors. The Masaoka staging system does not seem to reliably predict outcome.
    American Journal of Clinical Pathology 07/2012; 138(1):103-14. DOI:10.1309/AJCP88FZTWANLRCB · 2.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Malignant serous cavity effusion caused by primary thyroid cancer is extremely rare in routine clinical practice. Therefore, it is often not included in the differential diagnostic workup of patients presenting with positive effusion cytology. Methods: The clinical features were reviewed for 6 patients seen at our institution over the last 26 years for malignant effusion resulting from metastatic thyroid cancer. The cytomorphology from 4 of these cases was also reviewed. Results: All of the patients found in this study presented with malignant pleural effusion - other serous cavity effusions resulting from metastatic thyroid carcinoma were not seen. These comprised 0.25% of all patients with a known history of thyroid carcinoma and 0.67% of all malignant pleural effusions. One patient had a history of bone metastases, but all the others had no pathological evidence of distant metastatic disease prior to the pleural effusion. Conclusions: Malignant pleural effusion rarely results from a thyroid carcinoma after some latency. The diagnosis requires immunohistochemical staining as well as the pertinent clinical context.
    Acta cytologica 03/2013; 57(2):177-83. DOI:10.1159/000345696 · 1.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The clinical characteristics, pathological subtypes and patients' survival in 40 patients with thyroid carcinoma between March 2007 and March 2012 were evaluated. This study included 33 (82.5 %) females and seven (17.5%) males (female to male ratio of 4.7:1). The median age of patients was 47.5 (range; 24-64). Papillary carcinoma was the commonest pathological subtype (23 patients, 57.5%), followed by follicular carcinoma (14 patients, 35%) and medullary carcinoma (3 cases, 7.5%). Total thryoidectomy was performed in 30 (75%), lobectomy in six (15%), subtotal and multifocal thryoidectomy in two (5%) patients. The median time of follow up was 3 years with range of 1-5 years. After ive years 34 (85%) patients were alive and six (15%) were dead. The overall 5-year actuarial survival was 85%, for papillary carcinoma 91.3%, for follicular carcinoma 85.7% and for medullary carcinoma it was 33.3%. The results suggest that total thryoidectomy had better outcome in comparison with other surgeries.
    Medicinski glasnik 02/2013; 10(1):164-7. · 0.20 Impact Factor
Show more