Thymic Carcinosarcoma Consisting of Squamous Cell Carcinomatous and Embryonal Rhabdomyosarcomatous Components
A case of thymic carcinosarcoma in an 83-year-old Japanese man is presented. He died of superior vena cava syndrome caused by a rapidly enlarged anterior mediastinum tumor eight months after initial symptoms. Autopsy revealed a 16 × 12 × 25 cm-sized, tan yellow, whitish tumor with a multinodular and...
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| Published in | Pathology, research and practice Vol. 197; no. 3; pp. 205 - 210 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
Elsevier GmbH
2001
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| Online Access | Get full text |
| ISSN | 0344-0338 1618-0631 |
| DOI | 10.1078/0344-0338-00035 |
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| Abstract | A case of thymic carcinosarcoma in an 83-year-old Japanese man is presented. He died of superior vena cava syndrome caused by a rapidly enlarged anterior mediastinum tumor eight months after initial symptoms. Autopsy revealed a 16 × 12 × 25 cm-sized, tan yellow, whitish tumor with a multinodular and microcystic appearance located in the left anterior mediastinum, which involved the residual thymus. The tumor had directly invaded the left pleura, and had metastasized to the right lung and spleen. Histologic examinations of the primary tumor showed a sarcomatous component consisting of racquet- or spindle-shaped cells with cross striations, and small nests of atypical squamous cells scattered throughout the tumor; neither transition between the two components nor intermediate cells with both epithelial and mesenchymal features was seen. Electron microscopic and immunohistochemical examinations confirmed the rhabdomyomatous differentiation of the sarcomatoid component. To our knowledge, there have been only two reported cases showing histologic features similar to the present tumor. For the histogenesis of thymic carcinosarcoma, we propose two hypotheses. The first is that sarcomatous cells are derived from carcinomatous cells by tumoral metaplasia. Secondly, that this type of tumor originates from thymic primitive cells with multidirectional differentiation potential. In accordance with the latter, we consider that the present tumor originated from thymic primitive cells. Thymic carcinosarcoma is a highly malignant tumor, and most patients die within a year. Appropriate therapies must be developed. |
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| AbstractList | A case of thymic carcinosarcoma in an 83-year-old Japanese man is presented. He died of superior vena cava syndrome caused by a rapidly enlarged anterior mediastinum tumor eight months after initial symptoms. Autopsy revealed a 16 × 12 × 25 cm-sized, tan yellow, whitish tumor with a multinodular and microcystic appearance located in the left anterior mediastinum, which involved the residual thymus. The tumor had directly invaded the left pleura, and had metastasized to the right lung and spleen. Histologic examinations of the primary tumor showed a sarcomatous component consisting of racquet- or spindle-shaped cells with cross striations, and small nests of atypical squamous cells scattered throughout the tumor; neither transition between the two components nor intermediate cells with both epithelial and mesenchymal features was seen. Electron microscopic and immunohistochemical examinations confirmed the rhabdomyomatous differentiation of the sarcomatoid component. To our knowledge, there have been only two reported cases showing histologic features similar to the present tumor. For the histogenesis of thymic carcinosarcoma, we propose two hypotheses. The first is that sarcomatous cells are derived from carcinomatous cells by tumoral metaplasia. Secondly, that this type of tumor originates from thymic primitive cells with multidirectional differentiation potential. In accordance with the latter, we consider that the present tumor originated from thymic primitive cells. Thymic carcinosarcoma is a highly malignant tumor, and most patients die within a year. Appropriate therapies must be developed. |
| Author | Ito, Takaaki Kitamura, Hitoshi Okudela, Koji Sano, Jin-yu Nakamura, Nabuo |
| Author_xml | – sequence: 1 givenname: Koji surname: Okudela fullname: Okudela, Koji email: kojixok@med.yokohama-cu.ac.jp organization: Department of Pathology, Yokohama City University School of Medicine, Yokohama, Japan – sequence: 2 givenname: Nabuo surname: Nakamura fullname: Nakamura, Nabuo organization: Division of Pathology, Yokohama Citizens Municipal Hospital, Yokohama, Japan – sequence: 3 givenname: Jin-yu surname: Sano fullname: Sano, Jin-yu organization: Division of Pathology, Yokohama Citizens Municipal Hospital, Yokohama, Japan – sequence: 4 givenname: Takaaki surname: Ito fullname: Ito, Takaaki organization: Department of Pathology, Yokohama City University School of Medicine, Yokohama, Japan – sequence: 5 givenname: Hitoshi surname: Kitamura fullname: Kitamura, Hitoshi organization: Department of Pathology, Yokohama City University School of Medicine, Yokohama, Japan |
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| Cites_doi | 10.1016/0046-8177(94)90205-4 10.1097/00000478-199306000-00012 10.1097/00000478-198207000-00007 10.1097/00000478-198610000-00007 10.1097/00000478-199906000-00009 10.1016/S0022-5223(19)43217-0 10.1002/1097-0142(19910215)67:4<1025::AID-CNCR2820670427>3.0.CO;2-F 10.1111/j.1365-2559.1992.tb00385.x 10.1111/j.1440-1827.1997.tb04489.x 10.1097/00000478-197706000-00002 10.1007/BF01600260 10.1002/path.1711720103 10.1016/S0344-0338(11)80767-3 10.1016/0007-0971(72)90050-2 10.1038/256493a0 10.1007/s004280050064 |
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| Keywords | Embryonal rhabdomyosarcoma Squamous cell carcinoma Carcinosarcoma Thymus |
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| SubjectTerms | Carcinosarcoma Embryonal rhabdomyosarcoma Squamous cell carcinoma Thymus |
| Title | Thymic Carcinosarcoma Consisting of Squamous Cell Carcinomatous and Embryonal Rhabdomyosarcomatous Components |
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