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Cortical versus medullary thymomas: a useful morphologic distinction?

M J Kornstein1, W J Curran, A T Turrisi

  • 1Department of Pathology, Medical College of Virginia, Richmond 23298-0662.

Human Pathology
|November 1, 1988
PubMed
Summary

Thymoma classification based on epithelial cell morphology is not prognostically useful. Invasive thymomas have a higher recurrence rate, but histologic categories do not significantly impact relapse-free survival.

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Area of Science:

  • Oncology
  • Pathology
  • Immunohistochemistry

Background:

  • Thymomas are epithelial tumors of the thymus.
  • Accurate classification and prognostic indicators for thymomas are crucial for patient management.

Purpose of the Study:

  • To evaluate if thymoma classification based on epithelial cell morphology is prognostically significant.
  • To compare the prognostic utility of morphologic classification with traditional histologic categories.

Main Methods:

  • Classified 100 thymic epithelial tumors based on resemblance to cortical/medullary epithelium and traditional categories.
  • Obtained follow-up data on 78 patients to assess tumor invasiveness and recurrence.
  • Utilized immunohistochemistry to analyze tumor markers including keratin, chromogranin, CEA, EMA, Leu-7, NSE, and HLA-DR.

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Main Results:

  • Fifty-eight percent of tumors were invasive, with 19 invasive tumors relapsing versus none of the non-invasive tumors (P < .0001).
  • No significant differences in relapse-free survival were found among the different histologic categories.
  • Immunohistochemical markers showed variable expression, with no correlation between immunoreactivity and classification.

Conclusions:

  • Classification of thymomas solely on epithelial cell morphology is not clinically advantageous over traditional methods.
  • Tumor invasiveness is a significant factor in thymoma recurrence, but histologic classification does not predict relapse-free survival.