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Mediastinum

Thymic carcinoma

Lymphoepithelioma-like thymic carcinoma


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 3 March 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Type of poorly differentiated squamous cell carcinoma
● Almost always fatal

Case reports
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● 16 year old boy with secondary nephrotic syndrome (Pediatr Nephrol 2008;23:1001)
● Rare association of paraneoplastic syndrome of polymyositis (Clin Nucl Med 2009;34:686)

Micro description
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● Syncytial groups of large, anaplastic, polyhedral cells with indistinct cell boundaries, amphophilic cytoplasm, round / oval vesicular nuclei, prominent eosinophilic nucleoli, mixed with mature lymphocytes
● Micronodular growth pattern in stroma showing florid lymphoid hyperplasia; epithelial cell component shows unequivocal signs of malignancy characterized by cytological atypia and increased mitotic activity (Mod Pathol 2012;25:993)
● Brisk mitotic activity, narrow fibrovascular septae, variable necrosis

Micro images
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Syncytial epithelial cells and T cells

Large, round, vesicular nuclei with prominent nucleoli

Positive stains
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Large tumor cells:
● EMA, keratin

Negative stains
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Large tumor cells:
● CD3, CD15, CD20, CD30, CD43, CD45, CD45RO

End of Mediastinum > Thymic carcinoma > Lymphoepithelioma-like thymic carcinoma


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