Once diagnosed, robbins review of pathology pdf free download may be removed surgically. A third of all people with a thymoma have symptoms caused by compression of the surrounding organs by an expansive mass. Type AB if the tumor contains a combination of both cell types. Thymic cortical epithelial cells have abundant cytoplasm, vesicular nucleus with finely divided chromatin and small nucleoli and cytoplasmic filaments contact adjacent cells.
Thymic medullary epithelial cells in contrast are spindle shaped with oval dense nucleus and scant cytoplasm thymoma if recapitulates cortical cell features more, is thought to be less benign. Increased vascular enhancement on CT scans can be indicative of malignancy, as can be pleural deposits. Sometimes thymoma metastasize for instance to the abdomen. The diagnosis is made via histologic examination by a pathologist, after obtaining a tissue sample of the mass.
Selected laboratory tests can be used to look for associated problems or possible tumor spread. Surgery is the mainstay of treatment for thymoma. In children, however, postoperative immunity may be abnormal and vaccinations for several infectious agents are recommended. 10 years after surgical resection, and in the majority of cases also pleural recurrences can be removed. Prognosis is much worse for stage III or IV thymomas as compared with stage I and II tumors. Patients with stage III and IV tumors may nonetheless survive for several years with appropriate oncological management. Patients who have undergone thymectomy for thymoma should be warned of possible severe side effects after yellow fever vaccination.