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Does CT of Thymic Epithelial Tumors Enable Us to Differentiate Histologic Subtypes and Predict Prognosis?

Yeon Joo Jeong1, Kyung Soo Lee1, Jhingook Kim2, Young Mok Shim2, Jungho Han3 and O Jung Kwon4

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, South Korea.
2 Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
3 Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
4 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.



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  		Fig. 1. —58-year-old man with low-risk thymoma (type AB tumor). Enhanced transaxial CT scan (7-mm collimation) obtained at level of aortic arch shows 3.9 x 3.8 cm, round, anterior mediastinal mass (arrows) with smooth contour and homogeneous attenuation.

 


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  		Fig. 2A. —68-year-old woman with high-risk thymoma (type B3 tumor). Enhanced transaxial CT scan (7-mm collimation) obtained at level of aortopulmonary window shows 4.4 x 4.7 cm, round, anterior mediastinal mass with lobulated contour and central dotlike calcification (arrow). This lesion shows heterogeneous enhancement with some area of necrosis (arrowhead).

 


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  		Fig. 2B. —68-year-old woman with high-risk thymoma (type B3 tumor). Follow-up CT scan (7-mm collimation) obtained at level of basal segmental artery 34 months after A shows nodular thickening of pleura (arrow), suggesting pleural tumor implantation.

 


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  		Fig. 3A. —44-year-old man with thymic carcinoma (type C tumor). Enhanced transaxial CT scan (7-mm collimation) obtained at level of main bronchi shows 4.0 x 7.3 cm, heterogeneously enhancing anterior mediastinal mass (arrows) with irregular contour.

 


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  		Fig. 3B. —44-year-old man with thymic carcinoma (type C tumor). CT scan obtained 4 cm superior to A shows obliteration of left innominate vein by tumor invasion (arrowhead). Adjacent mediastinal fat plane (black arrows) is partially obliterated. Also note enlarged right upper paratracheal lymph node (white arrow).

 


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  		Fig. 3C. —44-year-old man with thymic carcinoma (type C tumor). CT scan obtained at level of intrahepatic inferior vena cava shows nodular and bandlike thickening of pleura (arrow), suggesting pleural tumor implantation. Follow-up CT scan obtained 10 months later (not shown) revealed hepatic and bone metastases.

 

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