Thymus Disorders

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Several different types of tumour occur in the thymus, usually presenting as an anterior mediastinal mass. These may be detected on chest radiograph as an incidental finding, or may produce disease by compression of adjacent structures. Occasionally attention is drawn to the thymus because of an autoimmune disease such a myasthenia gravis.
The main tumours of the thymus are:
Lymphomas,particularly T-lymphoblastic lymphoma, nodular sclerosing Hodgkin's disease, and sclerosing B-
cell lymphoma.
Germ-cell tumours (teratoma and seminoma) account for about 20% of mediastinal tumours. They
display a similar histological spectrum to that seen in the testis.
Neuroendocrine tumours are composed of neuroendocrine cells and resemble those seen
elsewhere. Clinically they may be associated with Cushing's syndrome.
Thymomas are derived from thymic epithelial cells (spindle-cell or round-cell types) with an infiltrate of
reactive lymphoid cells. They may be associated with myasthenia gravis, red cell aplasia, and non-organ-
specific autoimmune diseases. Although 80% of thymomas are benign, 20% of these lesions
behave as low-grade malignant tumours, infiltrating local structures with metastatic spread in about 10% of cases.
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