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It is a rare but most common invasive (malignant) neoplasm of the thymus gland. It is derived from the epithelial tissue of the organ. It takes various forms, which means that it is not always possible to make a correct diagnosis quickly.
Thymomas constitute only 0,2–1,5 percent. all malignant tumors. They most often attack between the ages of 40 and 60. About half of the cases of this tumor are detected by chance on a chest X-ray for a different reason. About 90 percent. of all thymomas appear as a tumor located in the mediastinum. Epidemiological data show that only 10 percent. thymomas metastasize to other organs and surrounding lymph nodes.
Thymoma – symptoms
Most patients experience non-specific symptoms as they experience cough, chest pain, and symptoms of narrowing of the airways. As the cancer grows in many patients, symptoms (so-called paraneoplastic) of a malfunctioning of the immune system may appear. Patients have symptoms characteristic of many autoimmune diseases, such as RA, systemic lupus, myasthenia gravis, and thyroiditis. Few patients experience autoimmune aplastic anemia and hypogammaglobulinemia. Disturbances in the immune system due to the presence of thymoma result from changes that take place in the T-cell subtypes. Hypogammaglobulinemia is associated with B-cell deficiency and immune disorders.
Thymoma – types
Thymoma is a cancer that originates in the epithelium, but its cells do not have abnormal cell structures (they do not have atypia). They are built like normal thymic cells. There are different types of this cancer.
– Type A (spindle cell or medullary thymoma) is 4-7 percent. all thymomas. The cells from which it is made have an oval or spindle-shaped shape. The nuclei of these cells do not have pathological features. Although the cancer can spread to adjacent organs, the prognosis for patients is very good.
– Type AB (mixed thymoma) occurs in 28-34 percent. cases. The tumor is usually composed of foci of medullary thymoma and lymphocyte-rich foci. The prognosis for patients is good.
– Type B1 (lymphocytic thymoma) is 9-20 percent. cases of this cancer. In this case, the tumors resemble a healthy thymus. However, regardless of the difficulties in diagnosing this type of thymoma, the prognosis for patients is good.
– Type B2 (cortical thymoma) concerns 20-36 percent. cancer cases. The tumor usually consists of a large number of normal lymphocytes and fewer groups of neoplastic epithelial cells with vesicular nuclei. Cortical thymoma has a worse prognosis than the types mentioned earlier.
– Type B3 (epithelial thymoma or highly differentiated thymic carcinoma) is found in 10-14%. cases. Its epithelial cells are round or polygonal in shape. They often do not have the characteristics of atypia. In 40 percent patients have long-term survival, i.e. 20 years.
– Type C (thymic carcinoma) is clearly characterized by atypia. Scientists believe it derives from a pre-existing thymoma. There are squamous cell carcinoma, thymic carcinoma resembling lymphocytic epithelioma, sarcomatic carcinoma of the thymus gland, clear cell carcinoma of the thymus gland, carcinoma of the mucocutaneous thymus gland, and undifferentiated carcinoma of the thymus gland.
Thymoma – Treatment
Scientists are still debating whether, in the case of thymomas, the severity of the cancer or its type is more important for the patient’s future. In any case, however, the basic treatment is surgery, the aim of which is to remove the entire tumor as accurately as possible. Sometimes, however, the purpose of the operation is only to reduce the mass of the tumor.
Irradiation is required if the tumor has not been completely removed or surgery has not been performed due to the location of the thymoma.
It is worth adding that in recent years the treatment of thymomas through the use of chemotherapy has become more and more important. The drugs that are usually given to patients with thymoma are Cisplatin and Ifosfamide.
Chemotherapy is increasingly used as the primary treatment for thymomas. However, the standards for such therapeutic management are not yet precisely developed.
Tekst: Anna Jarosz
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