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Rhabdomyomatous multilocular thymic cyst.

Runjan Chetty1, Anu Reddi

  • 1Department of Pathology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.

American Journal of Clinical Pathology
|June 24, 2003
PubMed
Summary

A rare multilocular thymic cyst with rhabdomyomatous elements was found in a 15-year-old boy. This unique thymic cyst likely originated from thymic myoid cells and thymomedullary system remnants.

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Area of Science:

  • Thoracic Pathology
  • Developmental Biology
  • Skeletal Muscle Histology

Background:

  • The thymus is a site for various pathologies due to its embryologic origins.
  • Multilocular thymic cysts are uncommon, and this case presents a novel association.

Observation:

  • A 15-year-old male presented with a month of chest pain, found to have an anterior mediastinal mass on imaging.
  • Computed tomography revealed a large, 15-cm, multilocular, fluid-containing cyst adjacent to the thymus.

Findings:

  • Histologic examination confirmed a multilocular cyst lined by mucinous, ciliated, and squamous epithelium.
  • A prominent finding was the presence of rhabdomyomatous elements, including spider cells and strap-like cells with cross-striations, likely originating from thymic myoid cells.
  • Thymic tissue with ducts and Hassall corpuscles was noted at the cyst periphery.

Implications:

  • This case represents the first reported instance of a multilocular thymic cyst with rhabdomyomatous differentiation.
  • The findings suggest a potential origin of these muscle elements from thymic myoid cells and the cyst from thymomedullary system remnants.
  • Understanding these rare thymic lesions contributes to the differential diagnosis of anterior mediastinal masses.

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