• Journal of Chest Surgery
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• v.32 no.8
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• pp.726-731
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• 1999

Background: The distinction between non-invasive and invasive or thymic carcinoma has been severely compromised by lack of objective morphological criteria. A reliable biological marker of tumor aggressiveness is, therefore, mandatory for predicting tumor behavior. Material and Method: Thirty thymic epithelial tumors, including 7 non-invasive thymoma, 10 invasive thymoma, and 13 thymic carcinoma of the Rosai's classification; and 5 stage I, 7 stage II, 2 stage III, and 3 stage IVa of the Masaoka stage of thymoma were investigated for expression of bcl-2 and p53 proteins by immunohistochemistry. Result: The thymic epithelial cells showed positive immunostain for bcl-2 in 0 (0%), 3 (30%), 8 (61.5%) of categories in the Rosai's classification respectively and in 0 (0%), 1 (14.3%), 2 (100%), 0 (0%) of stage I, II, III, IVa of the Masaoka stage respectively. Thymic carcinoma, and high stage thymoma had significantly higher proportion of bcl-2 expression than thymoma (p=0.021) and low stage thymoma (p=0.011). However, p53 showed no correlation with the histological subtypes nor with clinical aggressiveness. Bcl-2 expression appeared to be positively correlated with p53 immunoactivity (p=0.007, kappa=0.525). Conclusion: These date indicate that bcl-2 expression correlates with aggressiveness in thymic epithelial tumors, but further studies on mutation of p53 protein is necessary because bcl-2 expression appeared to be positively correlated with p53 immunoactivity.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.849-854
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• 1985

We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.83-87
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• 2008

Accessory cervical thymic tissue has been rarely reported. However, it should be included in the differential diagnosis of neck masses in children, along with branchial anomalies, lymph nodes and other tumors. This lesion occurs along the descending line of the thymus between the angle of mandible and superior mediastinum. A 2-month-old infant presented with an asymptomatic left sided neck mass. MRI revealed a well defined homogeneous mass in the deep lobe of left parotid gland. At operation, an easily identified soft tissue mass was found in the left submandibular area, measuring $3{\times}1.5cm$. It was completely excised. Microscopic examination revealed normal thymic tissue.

• YAKHAK HOEJI
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• v.59 no.4
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• pp.164-169
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• 2015

In the present study, we determined the effect of $18{\beta}$-glycyrrhetinic acid ($18{\beta}$-GA) in the mice model bearing xenografts of HT-29 human colon cancer cell line. Data from the cytotoxicity assay displayed that $18{\beta}$-GA induced cell death in HT-29. The cytotoxicity was enhanced as the $18{\beta}$-GA treatment was prolonged. In case of 72 hrs treatment, $LD_{50}$ of $18{\beta}$-GA was approximately $90{\mu}M$, and the efficacy at $100{\mu}M$ of $18{\beta}$-GA appeared to be equivalent to that of doxorubicin at $1{\mu}M$. Based on the in vitro data, we tested the anti-tumor effect of $18{\beta}$-GA in thymic mice (Balb/c strain). Xenograft tumors were generated by subcutaneous injection of HT-29 ($3{\times}10^6cells/mouse$) to mice and the mice were treated intraperitoneally with $18{\beta}$-GA ($50{\mu}g/time/mouse$) every other day for 4 times. The tumor volumes were measured for a period of 14 days. Data displayed that the $18{\beta}$-GA treatment reduced the tumor volumes (P < 0.05) as compared to control mice. However, this activity was demolished when athymic mice (Balb/c nu/nu) were used instead of thymic mice. This observation appeared that T lymphocyte played an important role in the anti-tumor activity. In conclusion, our results indicate that $18{\beta}$-GA has anti-tumor activity in HT-29 tumor-bearing mice, which may be associated with T cells.

• Tuberculosis and Respiratory Diseases
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• v.51 no.3
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• pp.281-288
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• 2001

Background : The most common anterior mediastinal tumors originate from the thymus. Among them, thymic carcinomas occur as an early local invasion and wide spread metastases. However, when squamous cell carcinoma in the thymus or mediastinum is identified, an occult primary lung cancer must be excluded because the histologic types resemble those found more typically in the lung. CD5 and cytokeratin immunohistochemical staining is useful in evaluating biopsy samples from those tumors. Squamous cell carcinoma of an unknown primary origin in the mediastinum is a rare occurrence and there are only a handful of case reports. Here we describe a case with an anterior mediastinal mass of squamous cell carcinoma with unknown primary origin. A resection of the mediastinal mass without an association with the lung was performed. Immunohistochemical stallings were positive using cytokeratin 13, and negative using CD5 and cytokeratin 7. This was followed by chemotherapy for presumed thymic carcinoma.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.272-289
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• 1989

Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.126-142
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• 2022

Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.55-60
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• 1997

We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%). and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed In 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's Iymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.103-108
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• 2004

Thymolipoma is rare benign tumor of the thymic gland and mostly occurs at anterior mediastinum. Thymolipoma comprises 2~9% of thymic tumor and less than 1% of mediastinal mass. Therefore, thymolipoma should be differentiated from anterior mediastinal tumor such as thymoma, germ cell tumor and lymphoma. These tumors resemble cardiomegaly, pleural effusion, basal atelectasis, pericardial tumor and cyst, pleural tumor, lung cancer and pulmonary sequestration, and differentiated from above mentioned diseases. Though most cases are asymptomatic, there can be dyspnea with compression of adjacent organ by mass effect, and myasthenia gravis. We experienced a thymolipoma simulating cardiomegaly and report the case with the review of literatures.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.715-719
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• 1990

Thymoma is defined as a neoplasm of the epithelialreticular framework cells of the thymus. The treatment of choice and the prognosis for patients with thymoma are still controversial subjects due to lack of a uniform histological classification and standardized criteria for typing thymic tumors. Between June 1985 and May 1989, eight patients underwent thymomectomy at the Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center. A clinical analysis was performed and the following result was obtained. In histologic cell type, epithelial type was 2 cases, lymphocytic type 3 cases, and mixed type was 3 cases. The clinical stage was classified by Masaoka’s classification that Stage I was 4 cases, Stage II; 2 cases, Stage III; 2 cases and Stage IV was none. Myasthenia Gravis was associated with thymoma in 5 patients. In 8 patients, thymomectomy were performed. Adjuvant radiotherapy was performed in one patient with Stage I due to suspicious tumor remnant and in Stage II, III patients routinely. Combined chemotherapy was performed in one patient with Stage III due to local recurrence. We concluded that the most important prognostic factor of thymoma is extent of tumor invasion. And the presence of Myasthenia Gravis is no more prognostic factor. Surgical resection of thymoma is treatment of choice, If local invasion or distant dissemination is present, postoperative radiotherapy and /or combined chemotherapy is recommended.