Thymus neoplasia Notes
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NOTES NOTES THYMUS NEOPLASIA GENERALLY, WHAT IS IT? PATHOLOGY & CAUSES ▪ Tumors in thymus (anterior mediastinum) TYPES ▪ Classiﬁed by cell from which tumors arise Thymoma, thymic cancers (most common) ▪ Thymic epithelial cells Neuroendocrine tumors ▪ Carcinoids Others ▪ Thymic hyperplasia, cysts, thymolipoma COMPLICATIONS DIAGNOSIS DIAGNOSTIC IMAGING ▪ Chest X-ray, CT scan LAB RESULTS ▪ Fine needle aspiration/core biopsy TREATMENT MEDICATIONS ▪ Chemotherapy/radiation therapy/both SURGERY ▪ Resection ▪ Bioactive substances → paraneoplastic syndromes SIGNS & SYMPTOMS ▪ Can be asymptomatic ▪ Chest pain, cough, dyspnea, paraneoplastic syndromes OSMOSIS.ORG 461
THYMOMA osms.it/thymoma PATHOLOGY & CAUSES ▪ Rare tumor from epithelial cells (thymus) ▪ Benign/malignant ▪ Localization ▫ Anterior superior mediastinum (most frequently) ▫ Atypical position (neck, thyroid, pulmonary hilum) ▪ Macroscopic characteristics ▫ Lobulated ▫ Firm ▫ Gray-white ▫ Containing cystic spaces/calciﬁcations/ hemorrhages TYPES ▪ Extension (Masaoka staging systems) Type I ▪ Encapsulated (non-invasive) Type II ▪ Invasion through capsula Type III ▪ Invasion into adjacent organs Type IV ▪ Local and distant implantations (metastases) COMPLICATIONS ▪ Mass effect (e.g. cardiac tamponade, respiratory problems); humoral effects (e.g. paraneoplastic syndromes), metastases, recurrences SIGNS & SYMPTOMS ▪ Asymptomatic; found incidentally during imaging studies ▪ Weight loss 462 OSMOSIS.ORG ▪ Fatigue ▪ Compression of mediastinal structures ▫ Esophagus → dysphagia ▫ Airways → cough, dyspnea ▫ Recurrent laryngeal nerve → hoarseness ▫ Superior vena cava (SVC) → SVC syndrome (face, arms edema; venous distension in neck, chest, arms) ▫ Chest pain Paraneoplastic syndromes ▪ Myasthenia gravis (most frequent, 30%) ▫ Muscle weakness ▫ Drooping eyelid (ptosis), double vision (diplopia) ▫ Dysphagia (difﬁculty swallowing) ▪ Pure red cells aplasia ▪ Hypogammaglobulinemia ▪ Graves disease ▪ Pernicious anemia ▪ Systemic lupus erythematosus ▪ Sjogren syndrome ▪ Dermatomyositis-polymyositis ▪ Cushing syndrome DIAGNOSIS DIAGNOSTIC IMAGING Chest X-ray ▪ Hyperdense mediastinal mass, calciﬁcations CT scan ▪ Well-deﬁned attenuation, cystic components, calciﬁcations MRI, nuclear medicine studies LAB RESULTS ▪ Fine-needle aspiration/core biopsy
Chapter 60 Thymus Neoplasia TREATMENT MEDICATIONS ▪ Surgical resection of thymus (thymectomy) OTHER INTERVENTIONS ▪ Pre/post-operative chemotherapy/ radiotherapy (advanced Masaoka stages) Figure 60.1 A CT scan in the axial plane demonstrating a large thymoma occupying the superior and anterior mediastinum. Figure 60.2 The gross pathology of a thymoma. OSMOSIS.ORG 463
Osmosis High-Yield Notes
This Osmosis High-Yield Note provides an overview of Thymus neoplasia essentials. All Osmosis Notes are clearly laid-out and contain striking images, tables, and diagrams to help visual learners understand complex topics quickly and efficiently. Find more information about Thymus neoplasia by visiting the associated Learn Page.