• The Korean Journal of Cytopathology
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• v.1 no.1
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• pp.43-50
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• 1990

The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic material were obtained in fifteen cases, establishing the diagnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.427-432
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• 1996

Eighteen patients operated on for thymoma from 1985 to 1994 were evaluated, 3 with myasthenia gravis and 15 without. Masaoka's clinical staging revealed stage I disease in 5(27.8%), stage ll in 6 (33.3%), stage 111 in 6(33.3%), and stage IV in 1 (5.6%). Of the 18 patients, 10 had surgical resection as the only treatment and the remaining 8 (stage II : 1 patient, stage III : 6 patients, stage IV: 1 patient) had surgical resection with adjuvant preoperative or postoperative radiotherapy and/or chemotherapy There was no operative mortality. Currently, 15 patients are alive, 3 are dead. The mean follow up time for all patients was 3.4 years. Acturlal survival at 5 years was 82.2 $\pm$ 9% for all patients' 100% for those in stage I and II, and 62.5% for those in stage III. Pleural and mediastinal recurrence developed in one patient in stage II which was considered to have noninvasive disease on the operating field. Two patients underwent reoperation for recurrence of thymoma a intervals of 14 months and 52 months. Clinical stage and resectability had a significant prognostic value(p < 0.05). The presence of myasthenia gravis is no longer considered as an adverse factor in survival.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.319-323
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• 1998

Thymic carcinoid tumor is a rare mediastinal tumor, which was firstly described by Rosai and Higa in 1972. A carcinoid tumor of the thymus has recently been regarded as a distinct tumor from thymoma, and is probably Kultschizky cell origin. The pathologic diagnosis of thymic carcinoid is made from findings from light microscopy, immunohistochemical studies and electron microscopy. About 50% of thymic carcinoids were seen with endocrinopathies. Recurrences and extrathoracic metastasis are characteristics of thymic carcinoids. Surgical removal of the intial and tumor recurred are considered to be the most effective treatment today. However, the role of the adjuvant radiotherapy and the chemotherapy is still uncertain. Herein we report a case of thymic carcinoid tumor, which was confirmed by operation and pathologic study.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.759-764
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• 2007

Background: Thymoma occurs in approximately 10% of myasthnia gravis patients. The thymus or a thymoma plays a role in the pathogenesis of myasthenia gravis. However, there is currently no definitive position about the effect of thymectomy on patients' symptoms and prognosis. We retrospectively studied the effect of thymoma on re-mission in patients who underwent thymectomy for myasthenia gravis. Material and Method: From July, 1992 to December, 2002, we performed extended thymectomy due to myasthenia gravis for 100 patients. The thymoma group included 30 people, the non-thymoma group included 70 people and the change of the Ossermann stage between the two groups after surgery was compared. Result: For the non-thymoma group, the average age was 34.7 years (range: $12.7{\sim}47.7$). Before the surgical operation, the Ossermann stage for the non-thymoma group was an average of 3.00, and this was reduced to an average of 1.41 after operation. For the thymoma group, the average age was 50.9 years (range: $37.3{\sim}64.5$). Before the surgical operation, the Ossermann stage for the thymoma group was an average of 3.00, and this was reduced to an average of 1.47 after operation. The non-thymoma patients had a higher proportion of males than the thymoma patients (35% vs 30%, respectively), The Masaoka stage was stage of the thymoma group was I for 27 patients and stage II for 3 patients. There was no statistically significant Ossermann stage change between the thymoma and non-thymoma groups. Conclusion: Whether thymoma was present or not, there was no significant difference on remission and improvement of myasthenia symptoms after thymectomy in the myasthenia gravis patients.

• Tuberculosis and Respiratory Diseases
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• v.62 no.4
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• pp.331-335
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• 2007

A thymoma commonly occurs in the superior mediastinum or the upper part of the anterior mediastinum but can be located in other places in rare cases. Cystic degeneration in a thymoma is a relatively common but focal event. In rare cases, the process proceeds to the extent that most if not all of the lesion becomes cystic. We report a case of a patient with a paracardial cystic thymoma in the lower aspect of the anterior mediastinum. A 49-year-old woman was referred to our hospital because of a mass discovered incidentally on a chest X-ray. She showed no symptoms or signs. Contrast-enhanced chest CT scan revealed a $5{\times}5cm$ sized, well-marginated, right paracardial cystic mass with a curvilinear and oval enhancing solid portion. A Surgical resection was performed. The mass was discontinuous with normal thymic tissue. Microscopy revealed a type B1 thymoma with prominent foci of medullary differentiation according to the WHO classification. There was no capsular or local invasion. The postoperative course was uneventful and the patient was discharged in good health.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.634-637
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• 2002

Thymic carcinoid or neuroendocrine tumor of thymus is a very rare disease and has poor prognosis due to frequent recurrence and distant metastasis. A 43-year-old man was refered to our hospital because of Rt. chest pain and tightness. Chest X-ray revealed $7{\times}8$cm sized mass on Rt. anterior mediastinum. Surgical excision was performed and light microscopic, immunohistochemical and electron microscopic findings were confirmed as atypical thymic carcinoid tumor with thymic cyst. The patient has been followed up without recurrence or distant metastasis postoperatively for 3 months to now. We report a case of atypical thymic carcinoid with thymic cysts.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.85-89
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• 2006

Good's syndrome (thymoma with immunodeficiency) is a rare cause of combined B and T cell immunodeficiency in adults. The clinical characteristics are increased susceptibility to bacterial infection and opportunistic viral and fungal infections. The most consistent immunological abnormalities are hypogammaglobulinemia and reduced or absent B cells. This syndrome should be treated by resecting the thymoma and replacing the immunoglobulin to maintain adequate IgG values. The author experienced one case of Good's Syndrome. The patient was a 64-year-old female who had a history of frequent sinopulmonary infection. Chest CT showed Pneumonia and anterior mediastinal mass and PCNB was taken and biopsy result was thymoma. She received thymectomy and replacement of immunoglobulin to control hypogammaglobulinemia.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.382-385
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• 2004

Non-typhoid salmonella infection frequently associated with bacteremia rarely been reported in immunocom-promized patients with malignant neoplasms, diabetes or extended use of corticosteroids. Especially, concomitant pleural empyema and pericarditis due to non-typhoid salmonella. infection is extremely rare. Here, we report a case of concomitant empyema and pericarditis in malignant thymoma with pleural. metastasis complicated by salmonella group D infection with brief review of literature.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.684-690
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• 2004

Background: Primary thymic epithelial neoplasm is a type of mediastinal tumors that have various biologic and morphologic features. In this study, we reclassified 59 cases of thymic epithelial tumors by the new WHO classification. We inquired whether the new WHO classification has independent prognostic relevance by analyzing clinical characteristics of thymic epithelial tumors including Masaoka's clinical stage. Material and Method: From December 1986 to August 2003, 59. patients who underwent surgery in the Keimyung University Dongsan Medical Center with definite diagnosis of thymic epithelial tumor were studied. We analyzed the histologic subtype (WHO classification). clinical stage (Masaoka's clinical stage) and patient's characteristics (sex, age, myasthenia gravis, tumor size, invasion. recurrence, metastasis) as prognostic factors. We analyzed the relationship between histologic subtype and clinical stage. Result: 32 patients were male and 27 were female. Mean age was 50.1$\pm$14.2. From WHO A to C, all thymic epithelial tumors were reclassified by the new WHO classification. Six patients (10.2%) had Type A, 7 (11.9%) had Type AB, 7 (11.9%) had Type B$_1$, 10 (16.9%) had Type B$_2$ and 7 (11.9%) had Type B$_3$, 22 (37.3%) had Type C. Two factors were shown by multivariate analysis to be associated with a favorable prognosis: completeness of resection (p=0.003) and non-invasiveness (p=0.001). The overall 5-year survival of the 59 patients was 53%, subtype A and AB were 92.3%, B$_1$ and B$_2$ were 70.2%, and B$_3$ and C were 26.1%. The association between histologic subtype and invasive behavior (stage) was statistically significant (p<0.001). Conclusion: The WHO classfication is not only a histologic classfication of the thymic epithelial tumors but also a significant prognostic factor that influence the survival of thymic epithelial tumors.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.734-740
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• 1996

The relative importance of various factors influencing the prognosis and survival in the treatment of thymoma is still controversial. Sixty ave patients operated on for thymoma from Jan. 1981 to Dec. 1994 were evaluated, 28 patients (43.1 %) with myasthenia gravis and 37 patients (56.9%) without. Masaoka staging revealed stage I disease in 28 patie ts(4).1%) , stage ll in 1) patients(20.0%), stage 111 In 22 patients(33.8%), stage IVa in 1 patients(1.5%), and stage IVb in 1 patient(1.5%). There was no operative mortality. A complete resection was performed in 48 patients (73.8%) patients, associated in 10 patients (15.4%) with postoperative adjuvant treatment(radiotherapy 5; chemotherapy 1: radio- and chemotherapy 4). Thymomas were found to be predominantly of the epithelial type in 16 patients(24.6%), predominantly Iymphocytic type in 18 patients(27.7%), and mlxed in 22 patients (33.9%). The overall 5- and 10-year survival rates were 87% and 82%, respectively, Factors indicating a poor prognosis included local invasion, incomplete excision, thymic carcinoma, advanced staging and myasthenia gravis. The de- gree of tumor invasion turned out to be the main prognostic factor, and treatment should be planned ac- cordingly. The prognosis is best predicted by the stage of the tumor as determined intraoperatively and is poorer in patie ts with incomplete resection than in those with complete resection of the thynoma. No recurrence developed In patients with stage I disease.