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Thymus, Lesions: Multimedia

Author: Tarakad S Ramachandran, MBBS, FRCP(C), FACP, Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital
Coauthor(s): Uma I Raghunathan, MD, Consulting Staff, Department of Neurology, Franklin Medical Center; Dharmesh Patel, MD, Staff Physician, Department of Neurology, State University of New York Upstate Medical University; Leslie Kohman, MD, Vice-Chair of Academic Affairs, Program Director, Thoracic Surgery Residency Program, Professor, Department of Surgery, State University of New York Upstate Medical University; Joyce A Strohl, MD, FACS, FACCP, Consulting Surgeon in Thoracic Surgery, Private Practice, Flint, MI; Amar Swarnkar, MD, Director, Interventional Neuroradiology, Neuroradiology Fellowship Program, Assistant Professor, Department of Radiology, State University of New York Upstate Medical University
Contributor Information and Disclosures

Updated: Jul 7, 2008

Multimedia

Fairly large thymus in an infant.
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Media file 1: Fairly large thymus in an infant.
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Fairly large thymus in an infant.

Fairly large thymus in an infant.

Gross appearance of a thymoma showing distinct mu...
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Media file 2: Gross appearance of a thymoma showing distinct multinodularity and scattered, focal cystic changes.
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Gross appearance of a thymoma showing distinct mu...

Gross appearance of a thymoma showing distinct multinodularity and scattered, focal cystic changes.

Normal thymus. The thymus is located anterior to ...
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Media file 3: Normal thymus. The thymus is located anterior to the aortic arch, and sometimes 2 lobes can be seen. The thymus is prominent in newborns, occupying most of the anterior mediastinum. After puberty, fat progressively infiltrates the thymic tissue. At age 40 years, the thymus is nearly completely replaced with fat, and only slight residual nodular density of thymic tissue remains. A, Normally prominent thymus at age 7 months. B, Thymus in a 9-year-boy. C, Increasing fatty infiltration of the thymus noted in a 20-year-old man. D, The thymus has involuted and is atrophic in a 38-year-old man. Only a few nodular attenuations are visible.
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Normal thymus. The thymus is located anterior to ...

Normal thymus. The thymus is located anterior to the aortic arch, and sometimes 2 lobes can be seen. The thymus is prominent in newborns, occupying most of the anterior mediastinum. After puberty, fat progressively infiltrates the thymic tissue. At age 40 years, the thymus is nearly completely replaced with fat, and only slight residual nodular density of thymic tissue remains. A, Normally prominent thymus at age 7 months. B, Thymus in a 9-year-boy. C, Increasing fatty infiltration of the thymus noted in a 20-year-old man. D, The thymus has involuted and is atrophic in a 38-year-old man. Only a few nodular attenuations are visible.

Low-lying thymoma. Plain chest radiograph shows a...
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Media file 4: Low-lying thymoma. Plain chest radiograph shows a mass lying against the right heart border.
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Low-lying thymoma. Plain chest radiograph shows a...

Low-lying thymoma. Plain chest radiograph shows a mass lying against the right heart border.

Thymoma. CT scan shows a homogeneous thymic mass.
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Media file 5: Thymoma. CT scan shows a homogeneous thymic mass.
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Thymoma. CT scan shows a homogeneous thymic mass.

Thymoma. CT scan shows a homogeneous thymic mass.

Malignant thymoma. Chest CT scan in a 61-year-old...
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Media file 6: Malignant thymoma. Chest CT scan in a 61-year-old man with myasthenia gravis demonstrates a large, lobulated mass with punctate calcification in the anterior mediastinum; these findings are consistent with a thymoma.
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Malignant thymoma. Chest CT scan in a 61-year-old...

Malignant thymoma. Chest CT scan in a 61-year-old man with myasthenia gravis demonstrates a large, lobulated mass with punctate calcification in the anterior mediastinum; these findings are consistent with a thymoma.

Thymolipoma. CT scan of the chest shows a large a...
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Media file 7: Thymolipoma. CT scan of the chest shows a large anterior mediastinal mass displacing the mediastinal vascular structures to the right and projecting into the left thorax. The tumor is composed of both soft tissue and fat, and a few punctate calcifications are present.
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Thymolipoma. CT scan of the chest shows a large a...

Thymolipoma. CT scan of the chest shows a large anterior mediastinal mass displacing the mediastinal vascular structures to the right and projecting into the left thorax. The tumor is composed of both soft tissue and fat, and a few punctate calcifications are present.

Thymic cystic teratoma. This thin-walled cystic m...
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Media file 8: Thymic cystic teratoma. This thin-walled cystic mass contains a fat-fluid level.
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Thymic cystic teratoma. This thin-walled cystic m...

Thymic cystic teratoma. This thin-walled cystic mass contains a fat-fluid level.

Thymolymphoma. Chest radiograph shows a large, lo...
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Media file 9: Thymolymphoma. Chest radiograph shows a large, lobulated mediastinal mass.
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Thymolymphoma. Chest radiograph shows a large, lo...

Thymolymphoma. Chest radiograph shows a large, lobulated mediastinal mass.

Thymolymphoma. Contrast-enhanced CT scan demonstr...
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Media file 10: Thymolymphoma. Contrast-enhanced CT scan demonstrates a large, lobulated, soft tissue mass in the anterior mediastinum that posteriorly displaces the aorta and pulmonary artery.
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Thymolymphoma. Contrast-enhanced CT scan demonstr...

Thymolymphoma. Contrast-enhanced CT scan demonstrates a large, lobulated, soft tissue mass in the anterior mediastinum that posteriorly displaces the aorta and pulmonary artery.

Marked regression of the mass shown in Image 10 a...
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Media file 11: Marked regression of the mass shown in Image 10 after treatment.
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Marked regression of the mass shown in Image 10 a...

Marked regression of the mass shown in Image 10 after treatment.

Invasive thymoma. Contrast-enhanced CT scan shows...
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Media file 12: Invasive thymoma. Contrast-enhanced CT scan shows a thymic mass with variable attenuations invading the adjacent mediastinum. Bilateral pleural effusions are also present, indicating pleural invasion.
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Invasive thymoma. Contrast-enhanced CT scan shows...

Invasive thymoma. Contrast-enhanced CT scan shows a thymic mass with variable attenuations invading the adjacent mediastinum. Bilateral pleural effusions are also present, indicating pleural invasion.

More on Thymus, Lesions

Overview: Thymus, Lesions
Imaging: Thymus, Lesions
Follow-up: Thymus, Lesions
Multimedia: Thymus, Lesions
References
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References

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  2. Higuchi T, Taki J, Kinuya S, et al. Thymic lesions in patients with myasthenia gravis: characterization with thallium 201 scintigraphy. Radiology. Oct 2001;221(1):201-6. [Medline].

  3. Rosado-de-Christenson ML, Galobardes J, Moran CA. Thymoma: radiologic-pathologic correlation. Radiographics. Jan 1992;12(1):151-68.

  4. Suster S, Rosai J. Thymic carcinoma. A clinicopathologic study of 60 cases. Cancer. Feb 15 1991;67(4):1025-32. [Medline].

  5. Fraser RS, Pare PD, Coleman N. Anterior mediastinal masses. In: Fraser RS, Muller NL, Colman N, Pare PD. Fraser and Pare's Diagnosis of Diseases of the Chest. 4th ed. Philadelphia, Pa: WB Saunders;. 1994: 2884.

  6. Viebahn R, Hiddemann W, Klinke F, von Bassewitz DB. Thymus carcinoid. Pathol Res Pract. Oct 1985;180(4):445-51.

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  12. Wilkins EW Jr, Grillo HC, Scannell JG, et al. J. Maxwell Chamberlain Memorial Paper. Role of staging in prognosis and management of thymoma. Ann Thorac Surg. Jun 1991;51(6):888-92. [Medline].

  13. Nishimura O, Naito Y, Noguchi Y, et al. Thymolipoma: a report of three cases. Jpn J Surg. Mar 1990;20(2):234-7. [Medline].

  14. Sinnathamby CS. Last's Anatomy Regional and Applied. 10th ed. Edinburgh: Churchill Livingstone;1999.

  15. Doppman JL, Oldfield EH, Chrousos GP, et al. Rebound thymic hyperplasia after treatment of Cushing''s syndrome. AJR Am J Roentgenol. Dec 1986;147(6):1145-7. [Medline].

  16. Siegel MJ, Glazer HS, Wiener JI, Molina PL. Normal and abnormal thymus in childhood: MR imaging. Radiology. Aug 1989;172(2):367-71. [Medline].

  17. Fujishita T, Kishida M, Taki H, Shinoda C, Miyabayashi K, Fujishita M, et al. Detection of primary and metastatic lesions by [18F]fluoro-2-deoxy-D-glucose PET in a patient with thymic carcinoid. Respirology. Nov 2007;12(6):928-30. [Medline].

  18. Koopmans KP, de Groot JW, Plukker JT, de Vries EG, Kema IP, Sluiter WJ, et al. 18F-dihydroxyphenylalanine PET in patients with biochemical evidence of medullary thyroid cancer: relation to tumor differentiation. J Nucl Med. Apr 2008;49(4):524-31. [Medline].

  19. Kaiser LR. Surgical treatment of thymic epithelial neoplasms. Hematol Oncol Clin North Am. Jun 2008;22(3):475-88. [Medline].

  20. Cameron SE, Alsharif M, McKeon D, Pambuccian SE. Cytology of metastatic thymic well-differentiated neuroendocrine carcinoma (thymic carcinoid) in pleural fluid: report of a case. Diagn Cytopathol. May 2008;36(5):333-7. [Medline].

  21. Tsuda E, Imai T, Matsumura A, Hisahara S, Nonaka M, Shiraishi H, et al. Thyrotoxic myopathy mimicking myasthenic syndrome associated with thymic hyperplasia. Intern Med. 2008;47(5):445-7. [Medline].

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Further Reading

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Keywords

thymus lesions, thymus tumors, thymic lesions, thymic tumors, thymic hyperplasia, thymoma, thymic cyst, carcinoma of the thymus, carcinoid tumor of the thymus and paraganglioma (thymic neuroendocrine tumors), nonseminomatous germ cell tumors, thymolipomas, thymic involvement in lymphoma and metastases, germ cell tumors (dermoid cyst, teratoma, seminoma)

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Contributor Information and Disclosures

Author

Tarakad S Ramachandran, MBBS, FRCP(C), FACP, Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital
Tarakad S Ramachandran, MBBS, FRCP(C), FACP is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners, American College of International Physicians, American College of Managed Care Medicine, American College of Physicians, American Heart Association, American Stroke Association, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, and Royal Society of Medicine
Disclosure: Abbott Labs  Honoraria Consulting; Teva Marion Honoraria Consulting; Boeringer-Ingelheim Honoraria Speaking and teaching

Coauthor(s)

Uma I Raghunathan, MD, Consulting Staff, Department of Neurology, Franklin Medical Center
Uma I Raghunathan, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Dharmesh Patel, MD, Staff Physician, Department of Neurology, State University of New York Upstate Medical University
Disclosure: Nothing to disclose.

Leslie Kohman, MD, Vice-Chair of Academic Affairs, Program Director, Thoracic Surgery Residency Program, Professor, Department of Surgery, State University of New York Upstate Medical University
Disclosure: Nothing to disclose.

Joyce A Strohl, MD, FACS, FACCP, Consulting Surgeon in Thoracic Surgery, Private Practice, Flint, MI
Disclosure: Nothing to disclose.

Amar Swarnkar, MD, Director, Interventional Neuroradiology, Neuroradiology Fellowship Program, Assistant Professor, Department of Radiology, State University of New York Upstate Medical University
Disclosure: Nothing to disclose.

Medical Editor

Kitt Shaffer, MD, PhD, Director of Undergraduate Medical Education, Associate Professor, Department of Radiology, Cambridge Health Alliance
Kitt Shaffer, MD, PhD is a member of the following medical societies: American Roentgen Ray Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

W Richard Webb, MD, Chief of Thoracic Imaging, Professor, Department of Radiology, University of California at San Francisco
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Kavita Garg, MD, Professor, Department of Radiology, University of Colorado Health Sciences Center
Kavita Garg, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Nothing to disclose.

 
 
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