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Adenocarcinoma of the thymus, enteric type: report of 2 cases, and proposal for a novel subtype of thymic carcinoma.

2例肠型胸腺腺癌的个案报道,并提议作为胸腺癌的一个新亚型

Moser B,Schiefer AI,Janik S,Marx A,Prosch H,Pohl W,Neudert B,Scharrer A,Klepetko W,Müllauer L

Abstract

We report 2 cases of primary thymic adenocarcinoma with enteric differentiation. One carcinoma occurred in a 41-year-old man as a 7-cm-diameter cystic tumor and the other one in a 39-year-old woman as a 6-cm-diameter solid mass. Both tumors were located in the anterior mediastinum. Clinical staging did not reveal any extrathymic tumor. Histologically, the tumors were classified as adenocarcinoma, not otherwise specified, and a mucinous (colloid) carcinoma, respectively. Immunohistochemically, both tumors were positive for cytokeratin 20 (CK20), CDX2, and carcinoembryonic antigen, reflecting enteric differentiation. A review of the literature on 43 other cases of primary thymic adenocarcinomas suggested 11 further cases with enteric differentiation, as assessed by CK20 and/or CDX2 expression. We propose that thymic adenocarcinoma with enteric differentiation represents a novel subtype of thymic carcinoma. It is mostly of mucinous morphology and frequently associated with thymic cysts. The clinical outcome is variable. Recognition of primary thymic adenocarcinoma with enteric differentiation is helpful for the differentiation from metastatic disease, mainly from the gastrointestinal tract.

摘要

我们报道了2例伴有肠型分化的胸腺原发性腺癌。一例为41岁男性,一个直径7厘米的囊性肿瘤;另一例为39岁女性,一个直径6厘米的实性肿瘤。两个肿瘤均位于前纵隔。临床分期未见任何胸腺外肿瘤。组织学上,肿瘤分类为腺癌,非特异型和黏液(胶质)癌。免疫组化上,两个肿瘤均细胞角蛋白20(CK20)、CDX2和癌胚抗原阳性,反映了肠型分化。回顾了文献上43例其他的原发性胸腺腺癌提示有11例伴有肠型分化,经CK20和/或CDX2表达证实。我们提议肠型分化的胸腺腺癌代表了一个新的胸腺癌亚型。它大多数是黏液形态,经常与胸腺囊肿相关。其临床结果各不相同。认识原发性肠型分化的胸腺腺癌对于鉴别转移性疾病、主要是来自胃肠道转移的疾病,是有帮助的。

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