By Saul Suster
The mediastinum is a digital compartment within the chest hollow space that's the seat of a number of very important organs and constructions that may be interested in a number of pathologic techniques, together with congenital and developmental abnormalities, inflammatory stipulations, and benign and malignant neoplasms. The Atlas of Mediastinal Pathology offers a pictorial survey of the most important sickness strategies which could impact this anatomic compartment, together with congenital and bought cysts, benign hamartomatous strategies, inflammatory methods related to the mediastinum, and benign and malignant neoplasms. The latter comprises tumors of the thymus (thymoma and thymic carcinoma), neuroendocrine neoplasms, germ mobile tumors, mesenchymal neoplasms, and hematolymphoid malignancies. using ancillary diagnostic equipment is illustrated, the place applicable, offering suggestions for pathologists in arriving on the right diagnosis.
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12 Spindle-cell thymoma with numerous small gland-like spaces, some of which are filled with eosinophilic proteinaceous material. The gland-like spaces can impart to the lesion a biphasic appearance that is reminiscent of biphasic synovial sarcoma Fig. 13 Higher magnification of spindle-cell thymoma with glandlike structures. The gland-like structures are lined by a layer of large, epithelioid cells resembling a glandular lining. Notice the monotonous spindle cells surrounding the gland-like structures; both stained positive with cytokeratin and p63 23 Fig.
25 Another aspect of spindle-cell thymoma with a microcystic growth pattern shows evenly spaced small cystic cavities surrounded by bland-appearing monotonous spindle-cell proliferation Fig. 27 A spindle-cell thymoma with a macrocystic growth pattern shows numerous small dilated perivascular spaces that have focally coalesced to form larger, macrocystic spaces. 1 Thymomas Fig. 28 A spindle-cell thymoma with a hemangiopericytoma-like growth pattern is characterized by multiple branching vascular spaces with open lumina surrounded by a dense spindle-cell population.
B) b Thymomas WHO type B are composed of cells with round vesicular nuclei with prominent, single eosinophilic nucleoli surrounded by an ample rim of lightly eosinophilic or amphophilic cytoplasm. 2 Histologic variants of spindle-cell (WHO type A) thymoma Fascicular Storiform Whorling (meningioma-like) Rosette forming Glandular Papillary Sclerosing Adenoid Micro- and macrocystic Hemangiopericytic Thymoma with trabecular, ribbon-like, and neuroendocrine-like growth patterns Thymoma with pseudosarcomatous stroma (metaplastic thymoma) Micronodular thymoma with B-cell hyperplasia Fig.
Atlas of Mediastinal Pathology by Saul Suster