Associations between computed tomography features of thymomas and their pathological classification

Area of Science:

• Thoracic oncology
• Diagnostic imaging
• Pathology

Background:

• Thymoma exhibits diverse histological and biological characteristics.
• Imaging findings of thymomas vary significantly.

Purpose of the Study:

• To correlate computed tomography (CT) findings of thymomas with Masaoka staging and World Health Organization (WHO) classification.
• To identify CT features associated with thymoma stage and risk.
• To improve diagnostic accuracy and treatment planning for thymoma.

Main Methods:

• Retrospective analysis of CT scans from 84 thymoma patients.
• Comparison of CT findings between Masaoka stages I/II and III/IV.
• Comparison of CT findings between WHO low-risk (A-B1) and high-risk (B2/B3) thymomas.

Main Results:

• Masaoka stage III/IV thymomas were larger (60 mm vs. 45 mm), more irregular in shape and contour, and showed higher rates of necrosis (59% vs. 28%) and calcification (33% vs. 12%) than stage I/II.
• High-risk WHO thymomas demonstrated more irregular shape and contour compared to low-risk thymomas.
• Significant differences in mediastinal invasion patterns were observed between high- and low-risk groups, including greater invasion of mediastinal fat, great vessels, pericardium, and lungs in high-risk thymomas.

Conclusions:

• Masaoka stage III/IV thymomas present with larger size, irregular morphology, and increased necrosis/calcification compared to earlier stages.
• High-risk WHO thymomas are characterized by irregular features and more extensive mediastinal invasion.
• CT findings can help differentiate thymoma stages and risk groups, aiding clinical management.