[Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 4)

[Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 4)

Continued of part 2: [Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 3)

Fig. 1.30 At higher magnification, an island of atrophic epithelium in

thymic involution shows clusters of small, oval to spindle cells with

scant cytoplasm and nuclei displaying evenly dispersed chromatin

without nucleoli. The cells in these islands of involuting thymus are

indistinguishable from those seen in spindle-cell thymomas

Fig. 1.31 Another microscopic residual island of involuting thymic

epithelium shows cystic dilatation of a gland-like structure. Small cystic 

structures like these are commonly present in the involuting thymus

of adults but seldom grow to a significant size

Fig. 1.32 Sclerosing mediastinitis encroaching on the trachea shows

dense, fibrous tissue replacing the mediastinal fat and containing scattered 

islands of inflammatory cells  

Fig. 1.33 At higher magnification, idiopathic sclerosing mediastinitis

shows extensive deposition of fi brous connective tissue, with sparse

inflammatory infi ltrate chiefly composed of plasma cells and small

lymphocytes  

Fig. 1.34 Entrapment of large nerve trunks by the fi brosing process is

a common feature observed in idiopathic sclerosing mediastinitis

Fig. 1.35 Ropelike, linear strands of keloidal collagen flanked by scant

fibroblastic and infl ammatory cells can sometimes be seen in idiopathic

sclerosing mediastinitis, creating a superfi cial resemblance to a solitary

fi brous tumor—a pitfall to be avoided in small biopsy samples

Fig. 1.36 The gross appearance of mediastinal thyroid goiter shows a

multinodular thyroid with a smooth outer surface. Ectopic goiters can

undergo the same spectrum of changes seen in thyroid goiters, including 

the development of thyroiditis and malignant transformation

Fig. 1.37 Scanning magnification of a mediastinal thyroid goiter

shows large, unencapsulated lobules containing follicles of varying

sizes filled with colloid

Fig. 1.38 At higher magnification, a hyperplastic nodule in a mediastinal 

thyroid goiter shows thyroid follicles filled with colloid and lined

by normal-appearing thyroid follicular cells with small, round nuclei

containing dispersed chromatin and small nucleoli

Fig. 1.39 Gross appearance of mediastinal ectopic parathyroid adenoma. 

Notice the smooth outer surface and pale tan-brown color of the

gland. Ectopic mediastinal parathyroid tissue can be an incidental

microscopic finding in tissues containing involuting thyroid removed

during thyroid surgery or mediastinal exploration for lymph nodes.

Rarely, these adenomas can be the site for the development of parathyroid carcinoma  

Continue part 5: [Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 5)

Suggested Reading

Aw D, Palmer DB. The origin and implication of thymic involution. Aging Dis. 2011;2:437–43.

Benton C, Gerard P. Thymolipoma in a patient with Grave’s disease. J Thorac Surg. 1966;51:428–32.

Cohen AJ, Thompson I, Edwards FH, Bellamy RF. Primary cysts and tumors of the mediastinum. Ann Thorac Surg. 1991;51:378–86.

Craddock DR, Peacock MJ, Allen PW. Giant lymph node hyperplasia of the mediastinum. Med J Aust. 1974;18:795–7.

De Giacomo T, Diso D, Anile M, Venuta F, Rolla M, Ricella C, et al. Thoracoscopic resection of mediastinal bronchogenic cysts in adults. Eur J Cardiothorac Surg. 2009;36:357–9.

De Montpreville VT, Dulmet EM, Nashashibi N. Frozen section diagnosis and surgical biopsy of lymph nodes, tumors and pseudotumors of the mediastinum. Eur J Cardiothorac Surg. 1998;13:190–5.

Den Bakker MA, Oosterhuis JW. Tumors and tumor-like conditions of the thymus other than thymoma: a practical approach. Histopathology. 2009;54:69–89.

Dominguez-Malagon H, Guerrero-Medrano J, Suster S. Ectopic poorlydifferentiated (insular) carcinoma of the thyroid. Report of a case presenting as an anterior mediastinal mass. Am J Clin Pathol. 1995;104:408–12.

Flieder DB, Suster S, Moran CA. Idiopathic fibroinfl ammatory (fi brosing/sclerosing) lesions of the mediastinum. A study of 30 cases with emphasis on morphologic heterogeneity. Mod Pathol. 1999;12:257–64.

Gui J, Mustachio LM, Su DM, Craig RW. Thymus size and age-related thymic involution. Aging Dis. 2012;3:280–90. Hajhosseini B, Montazeri V, Hajhosseini L, Nezami N, Beygui

RE. Mediastinal goiter: a comprehensive study of 60 consecutive cases with special emphasis on identifying predictors of malignancy and sternotomy. Am J Surg. 2012;203:442–7.

Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer. 1972;29:670–83.

Le Marc’hadour F, Pinel N, Pasquier B, Dieny A, Stoebner P, Couderc P. Thymolipoma in association with myasthenia gravis. Am J Surg Pathol. 1991;15:802–9.

Mathisen DJ, Grillo HC. Clinical manifestations of mediastinal fibrosis and histoplasmosis. Ann Thorac Surg. 1992;54:1053–8.

Moran CA, Suster S. Primary parathyroid tumors of the mediastinum: a clinicopathologic and immunohistochemical study of 17 cases. Am J Clin Pathol. 2005;124:1–5.

Moran CA, Zeren H, Koss MN. Thymofi brolipoma: a variant of thymolipoma. Arch Pathol Lab Med. 1994;118:281–2.

Moran CA, Rosado de Christensen M, Suster S. Thymolipoma: clinicopathologic review of 33 cases. Mod Pathol. 1995;8:741–4.

Noussios G, Anagnostis P, Natsis K. Ectopic parathyroid glands and their anatomical, clinical and surgical implications. Exp Clin Endocrinol Diabetes. 2012;120:604–10.

Payne WS, Larson RH. Acute mediastinitis. Surg Clin N Am. 1969; 49:999–1009.

Schowengerdt XG, Suyemoto R, Main FB. Granulomatous and fibrous mediastinitis: a review and analysis of 180 cases. J Thorac Cardiovasc Surg. 1969;57:365–79.

Sirivella S, Ford WB, Zikria EA, Miller WH, Samadani SR, Sullivan ME. Foregut cysts of the mediastinum. Results in 20 consecutively surgically treated cases. J Thorac Cardiovasc Surg. 1985;90:776–82.

Suster S, Rosai J. Multilocular thymic cysts: an acquired reactive process. Study of 18 cases. Am J Surg Pathol. 1991;15:388–98.

Suster S, Rosai J. The thymus. In: Mills SE, editor. Histology for pathologists. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 505–25.

Suster S, Barbuto D, Carlson G, Rosai J. Multilocular thymic cysts with pseudoepitheliomatous hyperplasia. Hum Pathol. 1991;22:455–60.

Wakely Jr PE. Cytopathology-histopathology of the mediastinum: epithelial, lymphoproliferative, and germ cell neoplasms. Ann Diagn Pathol. 2002;6:30–43.

This is only a part of the book : Atlas of Mediastinal Pathology  of authors: Saul Suster. If you want to view the full content of the book and support author. Please buy it here: https://www.amazon.com/Atlas-Mediastinal-Pathology-Anatomic/dp/149392673X