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Cystic Fluorodeoxyglucose-Avid Thymic Hyperplasia with Lymphoepithelial Sialadenitis-like Features
Mahiro Ishizumi1, Yoshito Yamada1, Shinsuke Shibuya2
1Department of Thoracic Surgery, Kyoto Katsura Hospital, Kyoto, Japan.
Interdisciplinary Cardiovascular and Thoracic Surgery
|December 8, 2025
Summary
This study reports a rare case of thymic hyperplasia with lymphoepithelial sialadenitis-like features (LESA-like TH) presenting as multiple masses with FDG uptake. This finding expands the imaging characteristics of this benign thymic lesion.
Area of Science:
- Thoracic Pathology
- Diagnostic Imaging
- Oncology
Background:
- Thymic hyperplasia with lymphoepithelial sialadenitis-like features (LESA-like TH) is a rare benign thymic lesion.
- It is occasionally associated with autoimmune diseases or MALT lymphoma.
Purpose of the Study:
- To report a unique case of LESA-like TH with multiple masses and FDG avidity.
- To broaden the understanding of the imaging spectrum for LESA-like TH.
Main Methods:
- Case presentation of a 47-year-old man with incidentally discovered anterior mediastinal masses.
- Contrast-enhanced computed tomography (CT) and positron emission tomography-CT (PET-CT) were utilized for imaging.
- Histopathological examination following total thymectomy confirmed the diagnosis.
Main Results:
- Incidental discovery of two anterior mediastinal masses.
- CT revealed irregularly walled cysts.
- PET-CT demonstrated partial fluorodeoxyglucose (FDG) uptake.
- Histopathology confirmed LESA-like TH.
Conclusions:
- This case is the first to document imaging-visible multiplicity in LESA-like TH.
- This is also the first report of FDG avidity in LESA-like TH.
- The findings expand the recognized imaging spectrum of this rare thymic lesion.
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