Thymic carcinoma

Topic Completed: 1 December 2012

Minor changes: 27 February 2020

Copyright: 2003-2020,, Inc.

PubMed Search: Thymic carcinoma[TI] general

Hanni Gulwani, M.B.B.S.
Page views in 2019: 9,484
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Cite this page: Gulwani H. Thymic carcinoma - general. website. Accessed May 29th, 2020.
Definition / general
  • By definition, has overt cellular anaplasia
  • Ages 50+, occasionally children
Diagrams / tables

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

Clinical features
  • Associated with hypercalcemia, elevated parathyroid hormone levels, pulmonary sarcoidosis
  • Not associated with paraneoplastic syndromes such as myasthenia gravis or pure red cell aplasia
  • Patients usually present with mass related symptoms
  • Aggressive clinical course
  • Must exclude other primaries, which are much more common (lung, trachea, bronchi, esophagus)
  • Usually squamous cell carcinoma and variants (lymphoepithelioma-like, basaloid)
  • Proposed staging system (Am J Clin Pathol 2012;138:115)
Radiology images

Contributed by Dr. Lina Hu, for Case of the Month #479:

Mass with irregular, infiltrative borders

Prognostic factors
  • May be less aggressive than commonly believed; important prognostic factors are lymph node status and tumor size (Am J Clin Pathol 2012;138:103)
Case reports
  • 47 year old Asian woman with malaise, weight loss, chest pain and shortness of breath (Case of the Month #479)
Gross description
  • Unencapsulated, no internal fibrous septation, firm / hard / gritty with gray-white cut surface, necrosis and hemorrhage
Microscopic (histologic) description
  • Usually cohesive cellular growth, regularly round / oval nuclear outlines, eosinophilic nucleoli, geographic necrosis
  • Usually foci of medullary differentiation, abortive Hassall corpuscles, rosettes, gland-like spaces, T lymphocytes; no perivascular spaces
  • Subtypes discussed as separate topics
Microscopic (histologic) images

Contributed by Dr. Lina Hu, for Case of the Month #479:

KIT / CD117


Positive stains
Negative stains
Electron microscopy description
  • Well formed desmosome-like intercellular junctions, cytoplasmic tonofilaments that may insert into junctional complexes
Differential diagnosis
Board review style question #1
Which two antibodies are most helpful in diagnosing thymic carcinoma?

A. CK5/6, 34bE12
B. CD5, p63
C. CEA, synaptophysin
D. p63, p40
E. KIT / CD117, INSM1
Board review answer #1
B. CD5 combined with p63 are helpful thymic markers.
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