Differentiating thymoma from thymic cyst in anterior mediastinal abnormalities smaller than 3 cm.
Thymic cyst
nomogram
thymoma
Journal
Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
entrez:
13
5
2020
pubmed:
13
5
2020
medline:
13
5
2020
Statut:
ppublish
Résumé
Computed tomography (CT) screening for lung cancer has led to frequent findings of small anterior mediastinal masses. It is very hard to distinguish small thymomas from thymic cysts. The objective of this study was to develop a clinical model for predicting small thymomas (<3 cm) in asymptomatic patients. Patients who underwent thymectomy for anterior mediastinal masses between 2004 and 2016 were included. All preoperative CT scans (pre- and post-enhanced) were retrospectively reviewed. Size, location, contour, shape, presence of calcification, and enhancement [Hounsfield units (HU)] were evaluated. A nomogram was built based on the predictive factors. For external validation, patients undergoing thymectomy in 2017 were enrolled and thymoma prediction was computed using the proposed nomogram. The study population consisted of 43 patients with thymoma and 57 with thymic cyst. The multivariable analysis identified a lobulated contour and a large difference in HU between post- and pre-enhancement as predictive factors of thymoma. These factors were included in the nomogram, which showed 95% (19/20) power for predicting thymoma after external validation. This clinical model can be used to predict thymoma in patients with small, asymptomatic thymic abnormalities on CT screening.
Sections du résumé
BACKGROUND
BACKGROUND
Computed tomography (CT) screening for lung cancer has led to frequent findings of small anterior mediastinal masses. It is very hard to distinguish small thymomas from thymic cysts. The objective of this study was to develop a clinical model for predicting small thymomas (<3 cm) in asymptomatic patients.
METHODS
METHODS
Patients who underwent thymectomy for anterior mediastinal masses between 2004 and 2016 were included. All preoperative CT scans (pre- and post-enhanced) were retrospectively reviewed. Size, location, contour, shape, presence of calcification, and enhancement [Hounsfield units (HU)] were evaluated. A nomogram was built based on the predictive factors. For external validation, patients undergoing thymectomy in 2017 were enrolled and thymoma prediction was computed using the proposed nomogram.
RESULTS
RESULTS
The study population consisted of 43 patients with thymoma and 57 with thymic cyst. The multivariable analysis identified a lobulated contour and a large difference in HU between post- and pre-enhancement as predictive factors of thymoma. These factors were included in the nomogram, which showed 95% (19/20) power for predicting thymoma after external validation.
CONCLUSIONS
CONCLUSIONS
This clinical model can be used to predict thymoma in patients with small, asymptomatic thymic abnormalities on CT screening.
Identifiants
pubmed: 32395273
doi: 10.21037/jtd.2020.02.14
pii: jtd-12-04-1357
pmc: PMC7212157
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1357-1365Informations de copyright
2020 Journal of Thoracic Disease. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.02.14). The authors have no conflicts of interest to declare.
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