Lung Tumors pp 169-204 | Cite as

Pathology of Mediastinal Tumors

  • B. J. Addis
Part of the UICC Current Treatment of Cancer book series (1360)

Abstract

Precise localization of a mediastinal tumor often helps to narrow the differential diagnosis (Table 1, Fig. 1) and modern imaging techniques can provide much information regarding its likely nature. However, treatment and prognosis depend on an exact histological diagnosis and this is greatly facilitated by correct handling of adequate tissue samples.

Keywords

Adenoma Sarcoma Amyloidosis Thyrotoxicosis Cholangitis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tao L-G, Pearson FG, Cooper JD, Sanders DE, Weisbrod G, Donat EE (1984) Cytopathology of thymoma. Acta Cytol 28: 165–170PubMedGoogle Scholar
  2. 2.
    Fish J, Moore RM (1963) Ectopic thyroid tissue and ectopic thyroid carcinoma: a review of the literature and report of a case. Ann Surg 157: 212–221PubMedCrossRefGoogle Scholar
  3. 3.
    Nathaniels EK, Nathaniels AM, Wang C-A (1970) Mediastinal parathyroid tumours: a clinical and pathological study of 84 cases. Ann Surg 171: 165–170PubMedCrossRefGoogle Scholar
  4. 4.
    Massac E Jr, Righini M, Seremetis M (1982) Mediastinal hyperfunctioning parathyroid adenoma. J Natl Med Assoc 74: 385–387PubMedGoogle Scholar
  5. 5.
    Lack EE (1981) Thymic hyperplasia with massive enlargement. Report of two cases with review of diagnostic criteria. J Thorac Cardiovasc Surg 18: 741–746Google Scholar
  6. 6.
    Cohen M, Hill CA, Cangir A, Sullivan MP (1980) Thymic rebound after treatment of childhood tumours. AJR 135: 151–156PubMedGoogle Scholar
  7. 7.
    Bell BA, Esseltine DW, Azouz EM (1984) Rebound thymic hyperplasia in a child with cancer. Med Pediatr Oncol 12: 144–147PubMedCrossRefGoogle Scholar
  8. 8.
    Levine GD, Rosai J (1978) Thymic neoplasia and hyperplasia. Hum Pathol 9: 495–517PubMedCrossRefGoogle Scholar
  9. 9.
    Addis BJ, Isaacson P. Unpublished observations.Google Scholar
  10. 10.
    Rosai J, Levine GD (1976) Tumours of the thymus. Atlas of tumour pathology. 2nd series. Fascicle 13. Armed Forces Institute of Pathology, Washington DCGoogle Scholar
  11. 11.
    Deshpande GN, Fisher JE, Jewett TC, Freeman AL (1981) Malignant thymoma in an eight-month old boy. J Surg Oncol 18: 61–66PubMedCrossRefGoogle Scholar
  12. 12.
    Wick MR, Scheithauer BW, Dines DE (1982) Thymic neoplasia in two male siblings. Mayo Clin Proc 57: 653–656PubMedGoogle Scholar
  13. 13.
    Yamashita H, Murakami N, Noguchi S, Noguchi A, Yokoyama S, Moriuchi A, Nakayama I (1983) Cervical thymoma and the incidence of cervical thymus. Acta Pathol Jpn 33: 189–194PubMedGoogle Scholar
  14. 14.
    Kung ITM, Loke SL, So SY, Lam WK, Mok CK, Khin MA (1985) Intrapulmonary thymoma: report of two cases. Thorax 40: 471–474PubMedCrossRefGoogle Scholar
  15. 15.
    Pascoe HR, Miner MS (1976) An ultrastructural study of nine thymomas. Cancer 37: 317–326PubMedCrossRefGoogle Scholar
  16. 16.
    Chan WC, Zaatari GS, Tabei S, Bibb M, Brynes RK (1984) Thymoma: an immunohisto-chemical study. Am J Clin Pathol 82: 160–166PubMedGoogle Scholar
  17. 17.
    Savino W, Berrih S, Dardenne M (1984) Thymic epithelial antigen, acquired during autogeny and defined by the anti-pl9 monoclonal antibody, is lost in thymomas. Lab Invest 51: 292–296PubMedGoogle Scholar
  18. 18.
    Chilosi M, Iannucci AM, Pizzalo G, Menestrina F, Fiore-Donati L, Janossy G (1984) Im-munohistochemical analysis of thymoma — evidence for medullary origin of epithelial cells. Am J Surg Pathol 8: 309–318PubMedCrossRefGoogle Scholar
  19. 19.
    Mokhtar N, Hsu S-M, Lad RP, Haynes BF, Jaffe ES (1984) Thymoma: lymphoid and epithelial components mirror the phenotype of the normal thymus. Hum Pathol 15: 378–384PubMedCrossRefGoogle Scholar
  20. 20.
    Masaoka A, Mandon Y, Nakahara K, Tanioka T (1981) Follow-up study of thymomas with special reference to their clinical stages. Cancer 48: 2485–2492PubMedCrossRefGoogle Scholar
  21. 21.
    Verley JM, Hollman KH (1985) Thymoma — a comparative study of clinical stages, histologie features and survival in 200 cases. Cancer 55: 1074–1086PubMedCrossRefGoogle Scholar
  22. 22.
    Marchevsky AM, Kaneko M (1984) Surgical pathology of the mediastinum. Raven, New YorkGoogle Scholar
  23. 23.
    Snover DC, Levine GD, Rosai J (1982) Thymic carcinoma. Five distinctive histological variants. Am J Clin Pathol 6: 451–470Google Scholar
  24. 24.
    Wick MR, Scheithauer BW, Weiland LH, Benatz PE (1982) Primary thymic carcinoma. Am J Surg Pathol 6: 613–630PubMedCrossRefGoogle Scholar
  25. 25.
    Shimosato Y, Kameya T, Nagai K, Suemasu K (1977) Squamous cell carcinoma of the thymus. An analysis of eight cases. Am J Surg Pathol 1: 109–121PubMedCrossRefGoogle Scholar
  26. 26.
    Leyvraz S, Henle W, Chahinian AP, Perlmann C, Klein G, Gordon RE, Rosenblum M, Holland JF (1985) Association of Epstein-Barr virus with thymic carcinoma. N Engl J Med 312: 1296–1299PubMedCrossRefGoogle Scholar
  27. 27.
    Henry K (1972) An unusual thymic tumour with a striated muscle (myoid) component (with a brief review of the literature on myoid cells). Br J Dis Chest 66: 291–299PubMedCrossRefGoogle Scholar
  28. 28.
    Murakami S, Shamoto M, Miura K, Takeuch J (1984) A thymic tumour with massive proliferation of myoid cells. Acta Pathol Jpn 34: 1375–1383PubMedGoogle Scholar
  29. 29.
    Rosai J, Levine G, Weber R, Higa E (1976) Carcinoid tumours and oat cell carcinomas of the thymus. Pathol Annu 11: 201–226PubMedGoogle Scholar
  30. 30.
    Wick MR (1982) Oat-cell carcinoma of the thymus. Cancer 49: 1645–1647CrossRefGoogle Scholar
  31. 31.
    Wick MR, Carney JA, Benatz PE, Brown LR (1982) Primary mediastinal carcinoid tumours. Am J Surg Pathol 6: 195–205PubMedCrossRefGoogle Scholar
  32. 32.
    Wick MR, Scheithauer BW (1984) Thymic carcinoid: a histologie, immunohistochemical and ultrastructural study of 12 cases. Cancer 53: 475–484PubMedCrossRefGoogle Scholar
  33. 33.
    Huntrakoon M, Lin F, Heitz PU, Tomita T (1984) Thymic carcinoid tumour with Cushing’s syndrome. Arch Pathol Lab Med 108: 551–554PubMedGoogle Scholar
  34. 34.
    Ho FCS, Ho JCI (1977) Pigmented carcinoid tumour of the thymus. Histopathology 1: 363–369PubMedCrossRefGoogle Scholar
  35. 35.
    Knapp RH, Hurt RD, Payne WS, Farrow MD, Lewis BD, Hahn RG, Muhm JR, Earle JD (1985) Malignant germ cell tumours of the mediastinum. J Thorac Cardiovasc Surg 89: 82–89PubMedGoogle Scholar
  36. 36.
    Lack EE, Wenstein HJ, Welch KJ (1985) Mediastinal germ cell tumours in childhood. J Thorac Cardiovasc Surg 89: 826–835PubMedGoogle Scholar
  37. 37.
    Nichols CR, Hoffman R, Einhorn LH, Williams SD, Wheeler LA, Garnick MB (1985) Hematologic malignancies associated with primary mediastinal germ-cell tumours. Ann Intern Med 102: 603–609PubMedGoogle Scholar
  38. 38.
    Hurt RD, Bruckman JE, Farrow GM, Benatz PE, Hahn RG, Earle JD (1982) Primary anterior mediastinal seminoma. Cancer 49: 1658–1663PubMedCrossRefGoogle Scholar
  39. 39.
    Knapp RH, Fritz SR, Reiman HM (1982) Primary embryonal carcinoma and choriocarcino-ma of the mediastinum. Arch Pathol Lab Med 106: 507–509PubMedGoogle Scholar
  40. 40.
    Carter D, Bibro MC, Touloukian RJ (1982) Benign clinical behaviour of immature mediastinal teratoma in infancy and childhood. Cancer 49: 398–402PubMedCrossRefGoogle Scholar
  41. 41.
    Dunn PJS (1984) Pancreatic endocrine tissue in benign mediastinal teratoma. J Clin Pathol 37: 1105–1109PubMedCrossRefGoogle Scholar
  42. 42.
    Holt S, Deverall PB, Boddy JE (1978) A teratoma of the lung containing thymic tissue. J Pathol 126: 85–89PubMedCrossRefGoogle Scholar
  43. 43.
    Oho HF, Lachenmeyer L, Janzen RWC, Gurtler KF, Fischer K (1982) Thymolipoma in association with myasthenia gravis. Cancer 50: 1623–1628CrossRefGoogle Scholar
  44. 44.
    Pillai R, Yeoh N, Addis B, Peckham M, Goldstraw P (1985) Thymolipoma in association with Hodgkin’s disease. J Thorac Cardiovasc Surg 90: 306–308PubMedGoogle Scholar
  45. 45.
    Lemos LB, Hamondi AB (1978) Malignant thymic tumour in an infant (malignant histiocyto-ma). Arch Pathol Lab Med 102: 84–89PubMedGoogle Scholar
  46. 46.
    Havlicek F, Rosai J (1984) A sarcoma of thymic stroma with features of liposarcoma. Am J Clin Pathol 82: 217–224PubMedGoogle Scholar
  47. 47.
    Kaplan HS (1980) Hodgkin’s disease. Harvard University Press, CambridgeGoogle Scholar
  48. 48.
    Keller A, Castleman B (1974) Hodgkin’s disease of the thymus gland. Cancer 133: 1615–1623CrossRefGoogle Scholar
  49. 49.
    Lindford KK, Meyer JE, Dedrick CG, Hasseil LA, Harris NL (1985) Thymic cysts in mediastinal Hodgkin’s disease. Radiology 156: 37–44Google Scholar
  50. 50.
    Barcos MP, Lukes RI (1975) Malignant lymphoma of convoluted lymphocytes. A new entity of possible T-cell type. In: Sinks LF, Godden JO (eds) Conflicts in childhood cancer. An evaluation of current management, vol 4, Liss, New York pp. 147–178Google Scholar
  51. 51.
    Nathwani BN, Kim H, Rappaport H (1976) Malignant lymphoma, lymphoblastic. Cancer 38: 964–983PubMedCrossRefGoogle Scholar
  52. 52.
    Crossman J, Chused TM, Fisher RI, Magrath I, Bollum F, Jaffe ES (1983) Diversity of immunologic phenotypes of lymphoblastic lymphoma. Cancer Res 43: 4486–4490Google Scholar
  53. 53.
    Yousem SA, Weiss LM, Warnke RA (1985) Primary mediastinal non-Hodgkin’s lymphomas: a morphologic and immunologie study of 19 cases. Am J Clin Pathol 83: 676–680PubMedGoogle Scholar
  54. 54.
    Waldron JA, Dohring EJ, Farber LR (1985) Primary large cell lymphomas of the mediastinal: an analysis of 20 cases. Semin Diagn Pathol 2: 281–295PubMedGoogle Scholar
  55. 55.
    Addis BJ, Isaacson PG (1985) Large cell lymphoma of the mediastinum: a B-cell tumour of probable thymic origin. Histopathology 10: 379–390CrossRefGoogle Scholar
  56. 56.
    Siegal GP, Dehner CP, Rosai J (1985) Histiocytosis X (Langerhans cell granulomatosis) of the thymus. Am J Surg Pathol 9: 117–124PubMedCrossRefGoogle Scholar
  57. 57.
    Davidson KG, Walbaum PR, McCormack RJM (1978) Intrathoracic neural tumours. Thorax 33: 359–367PubMedCrossRefGoogle Scholar
  58. 58.
    Enzinger FM, Weiss SW (1983) Soft tissue tumours. Mosby, St. LouisGoogle Scholar
  59. 59.
    Besznyak I, Toth L, Szende B (1985) Intrathoracic vagus nerve tumours: a report of two cases and review of the literature. J Thorac Cardiovasc Surg 89: 462–465PubMedGoogle Scholar
  60. 60.
    Staffanson K, Wollman R, Jerkovia M (1982) S100 protein in soft tissue tumours derived from Schwann cells and melanocytes. Am J Pathol 106: 261–268Google Scholar
  61. 61.
    Variend S (1985) Small cell tumours in childhood. J Pathol 145: 1–26PubMedCrossRefGoogle Scholar
  62. 62.
    Dhillon AP, Rhode J, Leathern A (1982) Neurone specific enolase: an aid to the diagnosis of melanoma and neuroblastoma. Histopathology 6: 81–92PubMedCrossRefGoogle Scholar
  63. 63.
    Kemshead JT, Goldman A, Fritschy J, Malpas JS, Pritchard J (1983) Use of panels of monoclonal antibodies in the differential diagnosis of neuroblastoma. Lancet 1: 12–14PubMedCrossRefGoogle Scholar
  64. 64.
    Misugi K, Okajima H, Newton WA, Kmetz DR, deLorimer AA (1965) Mediastinal origin of a melanotic progonoma or retinal anlage tumor: ultrastructural evidence for neural crest origin. Cancer 18: 477–484PubMedCrossRefGoogle Scholar
  65. 65.
    Adams A, Hochholzer L (1981) Ganglioneuroblastoma of the posterior mediastinum. A clin-icopathologic review of 80 cases. Cancer 47: 373–381CrossRefGoogle Scholar
  66. 66.
    Buthker W, Feltkamp-Vroom T, Groen AS, Wieberdink J (1964) Sympathicoblastoma of the anterior mediastinum. Dis Chest 46: 531–536CrossRefGoogle Scholar
  67. 67.
    Talerman A, Gratoma S (1983) Primary ganglioneuroblastoma of the anterior mediastinum in a 61-yr-old woman. Histopathology 7: 967–975PubMedCrossRefGoogle Scholar
  68. 68.
    Olson JL, Salyer WR (1978) Mediastinal paragangliomas (aortic body tumour): a report of four cases and a review of the literature. Cancer 41: 2405–2412PubMedCrossRefGoogle Scholar
  69. 69.
    Lack EE, Stillinger RA, Colvin DB, Groves RM, Burnette DG (1979) Aortico-pulmonary paraganglioma. Report of a case with ultrastructural study and review of the literature. Cancer 43: 269–278PubMedCrossRefGoogle Scholar
  70. 70.
    Ogawa J, Inoue H, Koide S, Kawada S, Shotitsu A, Hata J (1982) Functioning paraganglioma in the posterior mediastinum. Ann Thorac Surg 33: 507–510PubMedCrossRefGoogle Scholar
  71. 71.
    Nigan BK (1981) Intrathoracic chemodectoma with noradrenaline secretion. Thorax 36: 66–68CrossRefGoogle Scholar
  72. 72.
    Lichtenstein AK, Levine A, Taylor CR, Boswell B, Rossman S, Feinstein DI, Lukes RJ (1980) Primary mediastinal lymphoma in adults. Am J Med 68: 509–514PubMedCrossRefGoogle Scholar
  73. 73.
    Levitt LJ, Aisenberg AL, Harris NL, Linggood RM, Poppema S (1982) Primary non-Hodg-kin’s lymphoma of the mediastinum. Cancer 50: 2486–2492PubMedCrossRefGoogle Scholar
  74. 74.
    Keller AR, Hochholzer L, Castleman B (1972) Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer 29: 670–683PubMedCrossRefGoogle Scholar
  75. 75.
    Karcher DS, Pearson CE, Butler WM, Hurwitz MA, Cassell PF (1982) Giant lymph node hyperplasia involving the thymus with associated nephrotic syndrome and myelofibrosis. Am J Clin Pathol 77: 100–104PubMedGoogle Scholar
  76. 76.
    Weisenberger DD, Nathwani BN, Winberg CD, Rappaport H (1985) Multicentric angiofolli-cular lymph node hyperplasia. A clinicopathologic study of 16 cases. Hum Pathol 16: 162–172CrossRefGoogle Scholar
  77. 77.
    Frizzera G (1985) Castleman’s disease: more questions than answers. Hum Pathol 16: 202–205PubMedCrossRefGoogle Scholar
  78. 78.
    Melato M, Antoniutto G, Falconieri G, Manconi R (1983) Massive enlargement of mediastinal lymph nodes in a patient with multiple myeloma. Thorax 38: 151–152PubMedCrossRefGoogle Scholar
  79. 79.
    Thompson PJ, Jewkes J, Corrin B, Citron KM (1983) Primary bronchopulmonary amyloid tumour with massive hilar lymphadenopathy. Thorax 38: 152–154Google Scholar
  80. 80.
    Shaw P, Grossman R, Fernandes BJ (1984) Nodular mediastinal amyloidosis. Hum Pathol 15: 1183–1185PubMedCrossRefGoogle Scholar
  81. 81.
    Verani R, Olson J, Moake JL (1980) Intrathoracic extramedullary hematopoiesis: report of a case in a patient with sickle cell disease — beta-thalassemia. Am J Clin Pathol 73: 133–137PubMedGoogle Scholar
  82. 82.
    Kirwan WO, Walbaum PR, McCormack RJM (1973) Cystic intrathoracic derivatives of the foregut and their complications. Thorax 28: 424–428PubMedCrossRefGoogle Scholar
  83. 83.
    Salyer DC, Salyer WR, Eggleston JC (1977) Benign developmental cysts of the mediastinum. Arch Pathol Lab Med 101: 136–139PubMedGoogle Scholar
  84. 84.
    Luosto R, Koikkalainen K, Jyrala A, Makinen J (1978) Thoracic duct cyst of the mediastinum. A case report. Scand J Thorac Cardiovasc Surg 12: 261–263PubMedCrossRefGoogle Scholar
  85. 85.
    Tsuchiya R, Sugiura Y, Ogata T, Suemasu K (1980) Thoracic duct cyst of the mediastinum. J Thorac Cardiovasc Surg 79: 856–859PubMedGoogle Scholar
  86. 86.
    Pachter MR, Lattes R (1963) Mesenchymal tumours of the mediastinum. I Tumours of fibrous tissue, adipose tissue, smooth muscle and striated muscle. Cancer 16: 74–94PubMedCrossRefGoogle Scholar
  87. 87.
    Schweitzer DL, Aguam AS (1977) Primary liposarcoma of the mediastinum. J Thorac Cardiovasc Surg 74: 83–97PubMedGoogle Scholar
  88. 88.
    Prohn P, Winter J, Ulatowski L (1981) Liposarcoma of the mediastinum — case report and review of the literature. Thorac Cardiovasc Surg 29: 119–121CrossRefGoogle Scholar
  89. 89.
    Pachter MR, Lattes R (1963) Mesenchymal tumours of the mediastinum. II Tumours of blood vascular origin. Cancer 16: 95–107CrossRefGoogle Scholar
  90. 90.
    Pachter MR, Lattes R (1963) Mesenchymal tumours of the mediastinum. III Tumours of lymph vascular origin. Cancer 16: 108–117PubMedCrossRefGoogle Scholar
  91. 91.
    Kelley MJ, Mannes EJ, Ravin CE (1978) Mediastinal masses of vascular origin. A review. J Thorac Cardiovasc Surg 76: 559–572PubMedGoogle Scholar
  92. 92.
    Sumner TE, Volberg FM, Kiser PE, Shaffner LD (1981) Mediastinal cystic hygroma in children. Pediatr Radiol 11: 160–162PubMedCrossRefGoogle Scholar
  93. 93.
    Kissin MW (1977) Mediastinal cavernous hemangioma. Br J Dis Chest 71: 208–210PubMedCrossRefGoogle Scholar
  94. 94.
    Gibbs AR, Johnson NF, Giddings JC, Powell DEB, Jasani B (1984) Primary angiosarcoma of the mediastinum: light and electron microscopic demonstration of Factor VIII-related antigen in neoplastic cells. Hum Pathol 15: 687–691PubMedCrossRefGoogle Scholar
  95. 95.
    Rasaretnam R, Panabokke RG (1975) Leiomyosarcoma of the mediastinum. Brit J Dis Chest 69: 63–69PubMedCrossRefGoogle Scholar
  96. 96.
    Miller R, Kurtz SM, Powers JM (1978) Mediastinal rhabdomyoma. Cancer 42: 1983–1988PubMedCrossRefGoogle Scholar
  97. 97.
    Chen W, Chan CW (1982) Malignant fibrous histiocytoma of the mediastinum. Cancer 50: 797–800PubMedCrossRefGoogle Scholar
  98. 98.
    Kittredge RD, Nash AD (1974) The many facets of sclerosing fibrosis. AJR 122: 288–298Google Scholar
  99. 99.
    Light AM (1978) Idiopathic fibrosis of the mediastinum: a discussion of three cases and review of the literature. J Clin Pathol 31: 78–88PubMedCrossRefGoogle Scholar
  100. 100.
    Weider S, Rabinowitz JG (1977) Fibrous mediastinitis: a late manifestation of mediastinal histoplasmosis. Radiology 125: 305–312Google Scholar
  101. 101.
    Comings DE, Skubi KB, van Eyes J, Motulsky AG (1967) Familial multifocal fibrosclerosis. Ann Intern Med 66: 884–892PubMedGoogle Scholar
  102. 102.
    Hanly PC, Shub C, Lie JT (1984) Constrictive pericarditis associated with combined retroper-itoneal and mediastinal fibrosis. Mayo Clin Proc 59: 300–304Google Scholar
  103. 103.
    Engleman P, Liebow AA, Gmelich J, Friedman PJ (1977) Pulmonary hyalinizing granuloma. Am Rev Respir Dis 115: 997–1008PubMedGoogle Scholar
  104. 104.
    Magee JF, Wright JL, Dodek A, Tutassaura H (1984) Mediastinal and retroperitoneal fibrosis with fibrotic pulmonary nodules: a case report. Histopathology 9: 995–999CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • B. J. Addis

There are no affiliations available

Personalised recommendations