Micronodular thymic carcinoma with lymphoid hyperplasia: relevance of immunohistochemistry with a small panel of antibodies for diagnosis-a RYTHMIC study.
Aged
Aged, 80 and over
Antibodies
B-Lymphocytes
/ pathology
Carcinoma
/ pathology
Epithelial Cells
/ pathology
Female
Humans
Hyperplasia
/ metabolism
Immunohistochemistry
/ methods
Lymphatic Diseases
/ pathology
Male
Middle Aged
Neoplasm Recurrence, Local
/ pathology
Retrospective Studies
Thymoma
/ diagnosis
Immunohistochemistry
Micronodular thymic carcinoma with lymphoid hyperplasia
Thymic neoplasm
Journal
Virchows Archiv : an international journal of pathology
ISSN: 1432-2307
Titre abrégé: Virchows Arch
Pays: Germany
ID NLM: 9423843
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
25
07
2020
accepted:
24
01
2021
revised:
16
01
2021
pubmed:
26
2
2021
medline:
29
10
2021
entrez:
25
2
2021
Statut:
ppublish
Résumé
Micronodular thymic carcinoma with lymphoid hyperplasia (MNTCLH) is a rare form of thymic carcinoma. We present the experience of RYTHMIC, the French national network devoted to the treatment of thymic epithelial tumors through multidisciplinary tumor boards with a review of all tumors by pathologists for classification and staging. Six cases of MNTCLH were diagnosed during a review of 1007 thymic epithelial tumors. Histologically, epithelial cells with atypia and mitoses formed micronodules that were surrounded by an abundant lymphoid background with follicles. There was neither obvious fibro-inflammatory stroma nor necrosis. Spindle cells areas were common. Initial diagnosis was micronodular thymoma in two cases, cellular atypia being overlooked, eclipsed by the micronodular pattern. Immunohistochemistry with a panel of five antibodies showed that cytokeratins (AE1-AE3) and p63-positive epithelial cells also expressed CD5 and that there was no TdT-positive cells within the tumors. CD20 highlighted the lymphoid hyperplasia. Additionally epithelial cells also expressed CD117 and diffusely Glut 1. Twenty-seven micronodular thymomas with lymphoid stroma diagnosed during the same period did not show the CD5 and CD117 positivities seen in MNTCLH and contained TdT-positive lymphocytes. Three of the 6 patients with MNTCLH had adjuvant radiotherapy. Three patients with follow-up information were alive without recurrence at 38, 51, and 95 months. Our study shows that immunohistochemistry, such as that used in the RYTHMIC network with a small panel of antibodies, may easily help to confirm the correct diagnosis of MNTCLH, a rare and low-aggressive form of thymic carcinoma, and avoid the misdiagnosis of micronodular thymoma.
Identifiants
pubmed: 33629132
doi: 10.1007/s00428-021-03044-2
pii: 10.1007/s00428-021-03044-2
doi:
Substances chimiques
Antibodies
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
741-746Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
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