Thymic carcinoma: update of current diagnostic criteria and histologic types

Thymic carcinomas are rare tumors thought to derive from thymic epithelium. Because of the complex embryological origin of the thymus, whose development includes contributions from the third and, to a lesser extent, the fourth pharyngeal pouches, thymic carcinomas are endowed with great morphologic heterogeneity. A large number of histologic types have been described that resemble tumors arising in other organs. Unfortunately, no definitive pathognomonic histological features or immunohistochemical markers are associated with these tumors, making them a real challenge for diagnosis. Because of their close similarity with tumors arising at other organs, the diagnosis of thymic carcinoma must be regarded, for the most part, as a diagnosis of exclusion. This review will focus on current criteria for diagnosis of these tumors, with a review of the various histopathologic appearances that they can adopt.