Computed tomography and pathologic correlations of thymic lesions

Computed tomographic and pathologic correlations of the thymus gland were assessed in 69 patients. The sensitivity of computed tomography (CT) for undifferentiated thymic pathology is 87.1%; the specificity is 85.7%. The sensitivity of CT for neoplasm or mass is 97.1%, the specificity is 97.1%. The sensitivity of CT for lymphoid follicular hyperplasia (LFH) is 71.4%, the specificity is 97.6%. Therefore, a normal-sized thymus gland on CT does not exclude LFH. Completely preserved fat planes between thymic mass and adjacent structures on CT usually indicate a benign (noninvasive) neoplasm; completely absent fat planes usually indicate a malignant (invasive) neoplasm; partially preserved fat planes are indeterminate in assessing invasiveness. CT is also useful in showing recurrence or remnants of thymic tissue in patients who have had a previous thymectomy.