Morphological imaging of thymic disorders

Morphological imaging of thymic disorders (166 visite)

Camera L, Brunetti A, Romano M, Larobina M, Marano I, Salvatore M

Ann Med (ISSN: 0785-3890), 1999 Oct; 31(SUPPL.2): 57-62.

Tipo di articolo: Journal Article,

Impact factor: 2.566, Impact factor a 5 anni: 4.615

Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0032748321&partnerID=40&md5=e7f9e6f1a419bf053e86299f55f45353

Parole chiave: Computed Tomography, Magnetic Resonance Imaging, Neoplasm, Thymus, Anatomy, Cancer Invasion, Computer Assisted Tomography, Conference Paper, Diagnostic Accuracy, Human, Mediastinum, Myasthenia Gravis, Nuclear Magnetic Resonance Imaging, Priority Journal, Thymoma, Thymus Disease, Thymus Hyperplasia, Adult, Female, Thymus Gland, Thymus Neoplasms, X-Ray Computed,

Affiliazioni:

National Research Council, Dept. Biomorphological Funct. Sci., University Federico II, Naples, Italy
Department of Radiology, University Federico II, Via S Pansini 5, I-80131 Naples, Italy

Riferimenti:

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Schackelford, G. D., McAlister, W. H., The aberrantly positioned thymus: A cause of mediastinal and neck masses in children (1974) AJR Am J Roentgenol, 120, pp. 291-296

Hadden, J. W., Thymic endocrinology (1998) Ann N Y Acad Sci, 840, pp. 352-358

Baron, R. L., Lee, J. K. T., Sagel, S. S., Peterson, R. R., Computed tomography of the normal thymus (1982) Radiology, 142, pp. 121-125

Francis, I. R., Glazer, G. M., Brookstein, F. L., Gross, B. H., The thymus: Reexamination of age-related changes in size and shape (1985) AJR Am J Roentgenol, 145, pp. 249-254

Baron, R. L., Levitt, R. G., Sagel, S. S., Stanley, R. J., Computed tomography in the evaluation of mediastinal widening (1981) Radiology, 138, pp. 107-113

Moore, A. V., Korobkin, M., Olanow, W., Heaston, D. K., Ram, P. C., Dunnick, N. R., Age-related changes in the thymus gland: CT-pathologic correlation (1983) AJR Am J Roentgenol, 141, pp. 241-246

Fraser, R. S., Par, J. A. P., Fraser, R. G., Par, P. D., (1994) Diseases of the Chest, pp. 118-156. , Philadelphia: WB Saunders

Nicolaou, S., M ller, N. L., Li, D. K. B., Oger, J. J. F., Thymus in myasthenia gravis: Comparison of CT and pathological findings and clinical outcome after thymectomy (1996) Radiology, 201, pp. 471-474

Charles, R. J., Sabo, K. M., Kidd, P. G., Abkowitz, J. L., The pathophysiology of pure red cell aplasia: Implications for therapy (1996) Blood, 87, pp. 4831-4838

Urshel, J. D., Grewal, R. P., Thymectomy for myasthenia gravis (1998) Postgrad Med J, 74, pp. 139-144

Lewis, J. E., Wick, M. R., Scheithauer, B. W., Bernartz, P. E., Taylor, W. E., Thymoma: A clinicopathologic review (1987) Cancer, 60, pp. 2727-2743

Scatarige, J. C., Fishman, E. K., Zerhouni, E. A., Siegelman, S. S., Transdiaphragmatic extension of invasive thymoma (1985) AJR Am J Roentgenol, 144, pp. 31-35

Do, Y. S., Im, J. G., Lee, B. H., Kim, K. H., Oh, Y. W., Chin, S. Y., CT findings in malignant tumors of thymic epithelium (1995) J Comput Assist Tomogr, 19, pp. 192-197

Molina, P. L., Siegel, M. J., Glazer, H. S., Thymic masses on MR imaging (1990) AJR Am J Roentgenol, 155, pp. 495-500

The thymus is a bilobed lymphoid organ the morphology of which varies considerably with age as a result of a process of fatty infiltration occurring after puberty. Although several diseases can arise in the thymic parenchyma, including germ cell and neuroendocrine tumours, primitive epithelial neoplasms (thymomas) are the most common neoplasms and account for almost 10% of mediastinal masses. Thymomas are usually benign but can be locally invasive. Up to 30% of patients with a thymoma have myasthenia gravis, which is more commonly associated with thymic hyperplasia. The latter results in a symmetric diffuse enlargement of the thymus. However, thymic hyperplasia can be histologically found in up to 50% of normal-sized thymuses on computed tomography (CT). CT is much more accurate in detecting thymomas than it is in detecting thymic hyperplasia, although CT findings may be unspecific. C-T can be exhaustive in the case of an encapsulated thymoma (65% of all thymomas), which appear as a solid homogeneous mass with a slight contrast enhancement and a well-defined surrounding fat plane. These tumours rarely recur after surgery, CT can also accurately detect a spread through the capsule into the adjacent mediastinal fat, which characterizes invasive thymomas (35%). These, however, are best evaluated by magnetic resonance imaging (MRI). On T1-weighted MR scans the thymus is well delineated against the mediastinal fat, whereas marked inhomogeneity of the signal may appear on T2-weighted images as a result of areas of cystic degeneration in the tumour mass. The superior contrast resolution of MRI and the multiplanar images that can be produced with it are well suited for documenting the mediastinal spread of invasive thymomas. MRI depicts accurately pleural and/or pericardial implants as well as the involvement of great vessels, offering considerable aid in the planning of surgery.