[Pathology] Atlas of Thymic Epithelial Neoplasms (part 2), Thymic Epithelial Neoplasms. Atlas of Mediastinal Pathology
Fig. 2.10 Spindle-cell thymoma with prominent rosette-like structures.
The tumor shows numerous small, round structures containing
spindle to oval nuclei showing a palisaded arrangement toward the
periphery of the rosette-like structures that is reminiscent of
neuroblastic and primitive neuroectodermal neoplasms
Fig. 2.11 Higher magnification of rosette-like structures in spindle- cell
thymoma. The central portions of the structures contain eosinophilic
material that resembles the fibrillary material in Homer-Wright rosettes.
Thymomas with these features can be confused with metastases from
neuroblastoma and other neuroectodermal neoplasms or with neuroendocrine
neoplasms (carcinoid tumors and large cell neuroendocrine carcinoma).
The cells in these structures stain positive for cytokeratin and
p63 but are unreactive to neuroendocrine and neural markers
Fig. 2.12 Spindle-cell thymoma with numerous small gland-like
spaces, some of which are fi lled with eosinophilic proteinaceous material.
The gland-like spaces can impart to the lesion a biphasic appearance
that is reminiscent of biphasic synovial sarcoma
Fig. 2.13 Higher magnification of spindle-cell thymoma with glandlike structures.
The gland-like structures are lined by a layer of large,
epithelioid cells resembling a glandular lining. Notice the monotonous
spindle cells surrounding the gland-like structures; both stained positive
with cytokeratin and p63
Fig. 2.14 Spindle-cell thymoma with papillary architecture. Notice the
solid spindle-cell thymoma component (top left) that transitions
abruptly into areas with well-developed papillary tufts protruding into
empty spaces
Fig. 2.15 Higher magnification of spindle-cell thymoma with papillary
architecture. Notice that the cells populating the stroma of the
papillae are oval- to spindle-appearing and look bland. Tumors with
similar features but with invasive properties have been described as
“papillary thymic carcinoma”
Fig. 2.16 Spindle-cell thymoma with stromal sclerosis. The tumor
shows strands of spindle thymic epithelial cells embedded in an abundant
fibrocollagenous matrix. Tumors with these features can be mistaken
for schwannian neoplasms with prominent stromal degenerative changes
Fig. 2.17 Higher magnification of spindle-cell thymoma with stromal
hyalinization shows that the areas of stromal sclerosis correspond to
hyalinized dilated perivascular spaces
Fig. 2.18 Spindle-cell thymoma with “adenoid” growth pattern. The
tumor resembles a skin adnexal tumor and is composed of thin trabeculae
of round to oval tumor cells growing with a sieve-like architecture
with intervening loose myxoid stroma
Fig. 2.19 Higher magnification from spindle-cell thymoma with adenoid growth
pattern shows large, round to oval tumor cells with abundant cytoplasm
admixed with a sprinkling of small lymphocytes. Notice
that the intervening gland-like spaces correspond to dilated
perivascular spaces with stromal hyalinization
To be continue: [Pathology] Atlas of Thymic Epithelial Neoplasms (part 3)
Suggested Reading
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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
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