Images hosted on other servers:
Mediastinum anatomy, sagittal
Mediastinum anatomy, transverse
Histological structure of thymus
Thymus, hyperplasia, thymoma
Images hosted on other servers:
Morphology of thymus
Adult persistent thymus, cadaver
Normal thymus, 29 weeks gestation
Contributed by Nicole Stringham, Ph.D. (source: University of Michigan virtual slide box and Duke University virtual slide collection)
Neonatal thymus, lobule
Neonatal thymus, cortex / medulla
Neonatal thymus, Hassall corpuscle
Adult thymus, involuted
Adult thymus, medulla
Adult thymus, Hassall corpuscle
Images hosted on other servers:
Thymic hyperplasia
Mediastinum
Histology of the thymus
Images hosted on other servers:
Fluid filled mediastinal mass
Mediastinal mass with high signal intensity on T1 and T2
Mediastinal bronchogenic cyst
Well circumscribed
intrapulmonary
bronchogenic cyst
Esophageal bronchogenic cyst
Images hosted on other servers:
Submucosal esophageal bronchogenic cyst
Polypoid endobronchial bronchogenic cyst
Images hosted on other servers:
Unilocular cyst with mucoid material
Contributed by Laurence M. Briski, M.D.
Unilocular cyst
Recapitulation of bronchial structure
Cyst wall components
Foci of smooth muscle
Ciliated respiratory epithelium
Images hosted on other servers:
Cystic contents (Diff-Quik stain)
Images hosted on other servers:
Features of 4 patients
(tables 1 and 3)
Case #278
Atypical carcinoid
Atypical carcinoid -
AE1 / AE3
Atypical carcinoid - synaptophysin
Images hosted on other servers:
Figures a - d
Atypical carcinoid
Various stains
Gross, micro, IHC and serum markers of germ cell tumors
| Tumor type | Gross features | Microscopic features | Serum markers | Pankeratin | SALL4 | OCT3/4 | CD30 | Glypican 3 | Beta hCG | CD117 |
| Teratoma | Solid combined with cystic, Rokitansky protuberans contains shiny cartilage, hair and teeth, etc. | Derivatives of all 3 germinal layers | Beta hCG: normal LDH: normal AFP: normal | Positive in epithelial elements | Negative in mature components | Negative in mature components | Negative | Negative | Negative | Negative |
| Embryonal carcinoma | Gray-white with areas of hemorrhage and necrosis | Sheets and aggregates of highly pleomorphic cells | Beta hCG: normal LDH: raised AFP: raised | Positive | Positive | Positive | Positive | Negative | Negative | Negative |
| Yolk sac tumor | Gray-white with variable hemorrhage | Numerous growth patterns, Schiller-Duval bodies, eosinophlic globules | Beta hCG: normal LDH: normal AFP: raised | Positive | Positive | Negative | Negative | Positive | Positive in syncytio-trophoblasts | Negative |
| Chorio-carcinoma | Markedly hemorrhagic | Trimorphic population of trophoblasts with extensive hemorrhage | Beta hCG: raised LDH: normal AFP: normal | Positive | Negative | Negative | Negative | Negative | Positive in syncytio-trophoblasts | Negative |
| Seminoma | Gray-white, shiny cut surface | Islands of pleomorphic cells with prominent nucleoli, separated by thin fibrous septa having lymphocytes | Beta hCG: raised LDH: raised AFP: normal | Negative | Positive | Positive | Negative | Negative | Negative | Positive |
Contributed by David Suster, M.D.
Sheets of large round to oval tumor cells
Anastomosing cords, islands, comedonecrosis
Comedonecrosis
Lymphoepithelioma-like pattern
Desmoplastic pattern
Focal abrupt keratinization
p63
Contributed by David Suster, M.D.
Large, round tumor cell
2 desmosomal attachments
Images hosted on other servers:
Nests, ribbons and festoons
Various stains
Contributed by Jennifer M. Boland, M.D.
CT scan
Contributed by Jennifer M. Boland, M.D.
Monophasic synovial sarcoma
EMA
TLE1
Biphasic synovial sarcoma
Poorly differentiated synovial sarcoma
Contributed by Jennifer M. Boland, M.D.
SS18(SYT)-SSX1 fusion
Images hosted on other servers:
Mature cystic teratoma
Mature teratoma
Case #333
Various images
Images hosted on other servers:
Bland squamoid epithelium
Papillary outpouchings
Cholesterol clefts
Images hosted on other servers:
Incidental thymic follicular hyperplasia
Images hosted on other servers:
Pathogenesis associated with rheumatoid arthritis
Contributed by Azadeh Esmaeili, M.D. and Sarmad H. Jassim, M.D.
Increased lymphoid follicles
Germinal centers of different sizes
Germinal centers with tingible body macrophages
Frequent Hassall corpuscles
Images hosted on other servers:
Proposed stage T1, tumor limited to thymic gland
Proposed stage T2, tumor invades nearby structures
Proposed stage T3, direct (continuous) extrathoracic tumor extension beyond thoracic inlet or below diaphragm
Images hosted on other servers:
Mature adipose tissue admixed with unremarkable thymic tissue
| Stage | T | N | M | Tumor Extension |
| I | 1a 1b | 0 | 0 | Encapsulated or extending into mediastinal fat, no involvement of mediastinal pleura Invasion of mediastinal pleura |
| II | 2 | 0 | 0 | Invasion of pericardium |
| IIIA | 3 | 0 | 0 | Invasion into lung, brachiocephalic vein, superior vena cava, chest wall, phrenic nerve or extrapericardial pulmonary artery or veins |
| IIIB | 4 | 0 | 0 | Invasion into aorta (ascending, arch, or descending), arch vessels, intrapericardial pulmonary artery, myocardium, trachea, esophagus |
| IVA | Any | 1 0, 1 | 0 1a | Anterior (perithymic) lymph nodes Separate pleural / pericardial nodule(s) (implants) |
| IVB | Any | 2 Any | 0, 1a 1b | Deep intrathoracic / cervical lymph nodes Pulmonary intraparenchymal nodule, distant organ metastasis |
Recommended reporting of thymic epithelial tumors with multiple components (2021 WHO)
| Thymoma with > 1 histologic pattern (except AB thymoma) | List all thymoma subtypes, including percentages in 10% increments; start with predominant component |
| Thymoma and thymic carcinoma | List all components, including % in 10% increments; start with thymic carcinoma component independent of extent |
| Thymoma and thymic carcinoid tumor | List all components, including % in 10% increments; start with thymic carcinoid tumor component independent of extent |
Contributed by Anja C. Roden, M.D.
WHO type A thymoma
Contributed by Anja C. Roden, M.D.
Gross specimen of thymoma
Contributed by Anja C. Roden, M.D.
WHO type B3 thymoma
WHO type A thymomas, various patterns and atypical type A variant
WHO type A thymomas, various patterns and atypical type A variant
WHO type AB thymoma
WHO type AB thymoma
WHO type B1 thymoma
WHO type B2 thymoma
Thymoma: core needle biopsy
Thymoma: core needle biopsy
Thymoma: core needle biopsy
Micronodular thymoma with lymphoid stroma
Metaplastic thymoma
Lipofibroadenoma
Lipofibroadenoma
Thymoma with extensive sclerosis and ossification
Small thymic epithelial cell nest
Contributed by Anja C. Roden, M.D.
Cytology preparation of thymoma
Images hosted on other servers:
25 year old woman with pure red cell aplasia
Chest CT scan showing anterior mediastinal mass
Images hosted on other servers:
Intraoperative images following successful resection
Contributed by Azadeh Esmaeili, M.D. and Sarmad H. Jassim, M.D.
Expansion of normal component of thymic gland
Hassall corpuscles
Allen: 2015
Bardales: 2015
IARC: 2015
IARC: 2021
Mukhopadhyay: 2023
Shimosato: 2010
Suster: 2022
Find related Pathology books: cardiovascular, lung, mediastinum/serosa
