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SEMINAR on TUMORS of the THYHUS CASE I DIAGNOSIS S.P. I Ttl,Ymoma, Classical, Benign R75-1514 2 Thymoma, Lymphocytic Predominanc

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SEMINAR on TUMORS of the THYHUS CASE I DIAGNOSIS S.P. I Ttl,Ymoma, Classical, Benign R75-1514 2 Thymoma, Lymphocytic Predominanc SEMINAR ON TUMORS OF THE THYHUS CASE i DIAGNOSIS S.P. I 1 Ttl,Ymoma, classical, benign R75-1514 2 Thymoma, lymphocytic predominance UH75-2533 3 Mal ignant t hymoma, metastatic R76-91 4 t~ a l igna n t t hymoma in a chi ld R76 -1369 5 t~ a 1igna nt thymoma , sarcomatoid R76-1363 6 Hodgk in's disease of thymus UH74- 4:2.1.7. 7 Halignant lymphoma, lymphoblastic, of thymus R76-1219 8 lola 1i gnant lymphoma vs. thymoma R76-355 9 Yolk sac tumor of mediastinum R76-231 10 Carcinoid tumor of thymus R76-1291 SEMINAR ON PATHOLOGY OF THE THYMUS Or. Juan Rosai ' Professor of Pathology and Director of Anatomic Pathology University of Minnesota Medical School Minneapolis, Minnesota CASE 1 - (R75-1514; Courtesy of Dr . Thomas R. Hal l in, MethodistHospital, l~inn eapoli s). 66-year-old male with history of myasthenia gravis for 6 years, whi ch appeared fo 11 o~1i ng an appendectomy. The main symptoms were di pl opi a, bilateral ptosis and difficulty in chewi ng. A recent chest x-ray s ho1~ed a 6cm. mass located in the anterior mediastinum. Labora tory tests were normal. A thoracotomy was performed and an encapsulated tumor was found. The posterior aspect of this tumor was adherent to the pericardium. There were also fibrous adhesions with left lung and chest w~ll. CASE :2- (#UH75-2533): 25-year-old female 1~ith a history of chronic cough and corticaria. Chest x-rays showed a mass in the anterior mediastinum, which was removed in its entirety. Grossly, it was an encapsulated tumor measuring 9x8x5. Scm. The cross section was so 1i d, homogeneous, of a grayish white color. The slides are from this tumor. 8 months later, the patient consulted because of recurrence of the urticaria. A retroperitonea 1 lymph ­ angiogram sho~ted enlarged lymph nodes interpreted as suspicious of lymphoma. £ASE 3- (#R76-91; Courtesy of Dr . Richard J. Reed, Tulane University, New Orleans, Louisiana). 53-year-old male with history of mediastinal tumor excised in 1968. The tumor recurred locally some years later and metastases occurred, which led to the death of the patient. At autopsy, there was massive recurrence in the mediastinal region as ~tell as metastases in liver and bones. The Seminar slides are from the liver metastases. CASE 4 - (#R76-1369 ; Courtesy of Dr. John ~1. Temp 1eton, St. Joseph' s Hospital, Memphis, Tennessee). 11 -year-old girl with dyspnea and retrosternal oppression of short duration. Che st x-ra.Ys sh01~ed a large mass in the an t erior mediastinum, ~thich was biopsied. CASE 5- (#R76-1363; Courtesy of Dr. Wayne Chadbourn, Metropolitan Medical Center, Minneapolis). 67-year-old female with a tumor in anterior superior mediastinum. At operation, a soHd mass measuring 15cm in greatest diameter 1~as found invading the lung. CASE 6 - (#UH74-4212): 13-year-old girl 1~ith retrosternal oppression. Chest x-rays showed a large multinodular mass in anterior superior mediastinum. There was no cervical lymphadenopathY. A thoracotomy was performed and a multi­ nodular tumor ~tas found in the thymic region. A partial resection was carried out followed . by a course of radiation therapy. CASE 7- (#R76-1219; Courtesy of Dr. Nikola Kostich, Northwestern Hospital, 11inneapoli s). 24-year-old male, asymptomatic, with mass in anterior superior mediastinum found in a routine chest x-ray. At operation, an apparently encap­ sulated tumor ~tas found and this was easily removed. CASE 8- {#R76-355 ; Dourtesy of Dr. F.J. Martinez Tello, Ciudad Sanitaria 13 de Octubre, Madrid, Spain}. 24-year-old female in whom a routine chest x-ray showed a mass i n the anterior mediastinum. There ~1a s no previous symptomatology. The gross specimen showed a lOcm. tumor 1~hich wa s well circumscribed, except for an area of infi ltration into the lung. There was no evidence of mediastinal lymphadenopathy. CASE 9 - {GR76-231; Courtesy of Dr. Robert W. Weber, USAF Medical Center, Keesler Air Force Base, Mississippi}. 19-year-old male wi th large tumor mass in anterior superior medias tinum without evidence of distant metastases. The tumor was excised. The ~~eight was 400gms. and the dimen sions 12x8x6cm. It ~1as en ­ capsulated and showed a solid cross section of grayish color and multiple areas of necrosis , hemorrhage and cystic degeneration. The consistency was soft. CASE 10- {IR76-1291; Courtesy of Or. Thomas Swallen , North Memorial Hospital, Minneapolis). 35-year-old male. In 0Gtober 1975 a bronchial tumor was excised and diagnosed as carcinoid tumor. A yea r later a mediastinal mass measuring 6x3x3cm 1~as found in t he anterior superior mediastinum. Labor a tory tests showed persi stent elevation of serum calcium parathyroid hormone associated with decrease of phosphor us. The med iastinal mass was excised and t he neck was exposed. 3 large parathyroid glands were found and 2 of them were excised. The Seminar slides are from the mediastinal tumor. SEMINARIO SOBRE PATOLOGIA DEL TIMO Dr . Juan Rosa i Profesor de Patolog1a y Director de Anatom1a Patologica, Escuela de Medicina de la Un iversidad de Minnesota, 11inneapolis, Hinnesota, Estados Unido s. CASO 1 - (#R75 -1514; Cortesfa del Dr. Thomas R. Hallin , Methodist Hospital, Minneapolis) . Hombre de 66 anos con historia de miastenia gravis por 6 anos, aparecida luego de una apendectomfa. Los sintomas principales eran diplopia, ptosis bilateral y dificultad a la masticacion. Una radiografia de t6rax reciente mostr6 una masa de 6 em localizada en mediastina anterior. Las pruebas de labora­ torio eran norma les. Se efectu6 toracotomia, encontrandose un tumor encapsul ado cuya parte posterior estaba adherida al pericardia. Habia tambi en adherencias flbrosas entre pulm6n izquierdo y pared costal. ~. ·~~ CASO 2- (#UH75-2533): Mujer de 25 anos con historia de tos cr6nica y urticar1a. Radiograffa de t6rax revelo una masa en medi as tina anterosuperior, que fue extirpada en su totalidad. El aspecto macrosc6pico era el de un tumor encap­ sulado de 9x8x5.5 em. La superficie de corte era s6lida, homogenea, de color blanco grisaceo. Las laminillas del Seminario corresponden a este tumor. A los 8 meses de la operacion, la enferma consul to por recidiva de la urticaria. Lin­ fangiografia retroperitoneal demostro ganglios agrandados, interpretados como sospechosos de linfoma. CASO 3 - (#R76-91; Cortes1a del Dr. Richard J. Reed, Tulane University, Ne~1 Orleans, Louisiana) . Hombre de 53 anos con historia de tumor mediastinal extirpado en 1968. El tumor recidiv6 localmente unos anos despues y apa recieron metastasis a distancia que llevaron al fallecimiento del enfermo. En la autopsia, se encontr6 recidiva masiva en region mediastinal y metastasis en h{gado y huesos. Las la­ mini llas del Seminario corresponden a las metastasis hepaticas. CASO 4- (#R76-1369; Cortes1a del Or. John W. Templeton, St. Joseph's Hospital, Memph 1s , Tennessee}. Nina de 11 anos con sintomas de disnea y opresi6n retroes­ ternal de corta duraci6n. La radiografia de t6rax demostro una gran masa en media stina anterior, de la que se tom6 una generosa biopsia. CASO 5 - (R76-1363; Cortesia de 1 Or. Wayne Chadbourn , Metropolitan Medica 1 Center, Minneapolis} . Mujer de 67 anos con tumor en mediastina anterosuperior. Ala operaci6n , se encon t r6 una masa salida de 15 em de diametro maximo, con areas de invasion pulmon ar . CASO 6 - (#UH74-4212): Nina de 13 ano s que acude a la consulta por sensaci6n de opresion retroesternal. La radiograffa de t6rax muestra una gran masa multi­ lobulada ocupando mediastina anterosuperior. No hay evidencia de adenopat1a cervical. Se efectu6 toracotom1a, encontrandose un tumor multinodul ar en la region tfmica. Una reseccion parcial fue llevada a cabo , seguida por un curso de radio­ terapia. GASO 7 - (R76-1219; Cortesia del Dr. Nikola Kostich, North~1estern Hospital Minneapolis). Hombre de 24 anos, asintomatico, con masa en mediastina antero­ superior encontrada en radiografi'a de rutina. A la operaci6n, se encontr6 un tumor aparentemente encapsulado, que fue facilmente extirpado. CASO 8 - (#R76-355; Cortesia del Dr. F.J . Martinez Te llo, Ciudad Sanitaria l ~ de Octubre, Madrid, Espana). Muje r de 24 anos ala que se descubri6 en radio­ graffa de t6rax de rutina una masa en mediastina anterior. No habia sintomato­ logia previa. La pieza macrosc6pica correspondfa a una tumoraci6n de 10 em de diametro, que era bien delimitada salvo en una zona en que infi l traba el pulm6n. No habia evidencia de adenopat ias mediastinicas. CASO 9- (#R76-231; Cortesia del Or. Robert W. Weber, USAF Me dical Center, Keesler Air Force Base, 11ississippi). Hombre de 19 anos con gran masa tumoral en mediastina anterosuperior, sin evidencia de metastasis a distancia. El tumor fue y y extirpado. Pesaba 400 gm media 12xSx6 em. Estaba encapsulado tenia una super­ • ~I ficie de corte solida, de color grisaceo y multiples areas de necrosis, hemorragia l"t t ~·, y degeneracion qu1 stica. La consistencia era blanda. • CASO 10- (R76-1291; Cortesia del Dr. Thomas Swallen, North Memorial Hospital, 11inneapolis). Hombre de 35 aiios. En octubre de 1975, un tumor bronquial fue extirpado y diagnosticado como tumor carcinoide. Un aiio mas tarde presenta una masa mediastinal de 6x3x3 em en mediastina anterosuperior. Examenes de laboratorio demostraron elevaci6n persistente de calcio serico y hormona paratiroidea, asociadas con disminuci6n del fosforo. La masa mediastinal fue extirpada y elcuello fue exp1orado. Se encontraron tres glandulas pa ratiroideas agrandadas; dos de ellas f~eron extirpadas. Las laminillas del Seminario corresponden al tumor mediastinal. SENINARIO SOBRE PATOLOGIA DEL TI:10 Or. Juan Rosai Profesor de Patologfa y Director de Anatom1a Patologi ca, Escuel a de 1·1edicina de la Un i versidad de f·1innesota, f1inneapo lis , l'linnesota, Estados Unidos.
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