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Cancer of the thymus (cancer of the thymus)

  • What is Cancer of the thymus (cancer of the thymus)
  • What triggers / causes of Cancer of the thymus (cancer of the thymus)
  • Pathogenesis (what is happening) at the time of Cancer of the thymus (cancer of the thymus)
  • Symptoms of Cancer of the thymus (cancer of the thymus)
  • Diagnosis of Cancer of the thymus (cancer of the thymus)
  • Treatment of Cancer of the thymus (cancer of the thymus)
  • Which doctors should be consulted if You have Cancer of the thymus (cancer of the thymus)

What is Cancer of the thymus (cancer of the thymus) -

Cancer of the thymus (cancer of the thymus) is a group of rare (less than 5 tumors of the thymus) is an aggressive epithelial tumors, which are characterized by early locoregional and hematogenous metastasis. Mean age of patients was 46 years.

What triggers / causes of Cancer of the thymus (cancer of the thymus):

Causes of cancer of the thymus to date not been studied.

Pathogenesis (what is happening) at the time of Cancer of the thymus (cancer of the thymus):

In a group of cancers of the thymus gland are tumors of epithelial cells that have lost the signs organospecificity. Almost all tumors have rapid growth, infiltrating surrounding organs, implants give the pericardium and the pleura, metastasize rapidly.
Identify the following types of cancer of the thymus gland:
1) squamous cell carcinoma - lymphoepithelioma cancer
2) karcinosarkoma-
3) clear cell carcinoma-
4) mukoèpidermoidnuû cancer
5) papillary adenocarcinoma of the thymus.jpg" alt="Cancer of the thymus (cancer of the thymus)" />

Symptoms of Cancer of the thymus (cancer of the thymus):

Symptoms of cancer of the thymus gland in the early stages are absent. Dissemination of tumor to adjacent organs may experience respiratory distress, obstruction of outflow of blood from the superior Vena cava and its tributaries (cyanosis, swelling of the face and upper extremities, increased intracranial pressure, headaches), heart rhythm disturbances. When metastatic bones change possible severe pain, In the case of secondary neoplastic lesions of the brain develops focal neurological symptoms.
Malignant (atypical) thymoma 1st type is 20-25 of all epithelial tumors of the thymus. Its diameter is usually not more than 4-5 cm, occasionally it can reach large sizes. The tumor grows as either a single node or multiple lobed knots gray-pink in color, often without a clear capsule, but with a variety of secondary changes. Its growth is invasive in nature, do not go, however, beyond the body. There are two histological types of thymoma, cortical thymoma and well-differentiated thymic carcinoma.
Cortical thymoma (SYN.: thymoma with cortical cell differentiation, thymoma type B2) can be constructed from dark cells, light cells, or their various combinations:
- temnochilinae a kind (SYN.: small cell, spindle thymoma) presented randomly spaced bundles of small spindle-shaped cells with hyperchromatic nucleus and scanty, often difficult to see acidophilic cytoplasm is characterized by the formation of parisitology, železistopodobnyh and rosencopter structures with clusters lying outside the cells pink, homogeneous mass of this variety must be differentiated from neuroendocrine tumors (apoda), small cell lung cancer and metastatic lesions-
- clear cell carcinoma of the type built up of layers or bundles, formed of polygonal cells with light, often vakuolizirovannoj cytoplasm and vesicular nucleus - these cells are interconnected by cytoplasmic processes that form a network in cells which are lymphocytes - sometimes tumour cells are very light and even optically empty cytoplasm, so-called watery-cell thymoma, which should be differentiated from metastatic lesions.
Well-differentiated thymic carcinoma (SYN.: atypical thymoma, thymoma type EOI) is built up of layers or bundles of dark and light cells with increased proliferative activity and nuclear sites, less cellular polymorphism, expressed mainly in the periphery of the tumor. Invasive growth is expressed to a greater degree than cortical thymoma, but does not extend beyond the capsule of the thymus gland. The question of the possibility of metastasis of such tumors is discussed. The prognosis depends on the severity of the infestation. Five-year survival ranges from 80-90 .
Cancer of the thymus malignant thymoma 2nd type) is up to 5 all observations Tim.
Cancer node thymus can reach large sizes and is characterized by a strong invasive growth. As with other tumors, the most important prognostic factor is the stage of tumor invasion. Allocate six histological forms of cancer of the thymus gland: squamous cell (epidermoid), lymphoepithelial, spindle, undifferentiated (anaplastic), adenosquamous (mukoèpidermoidnuû), clear cell carcinoma.
Squamous cell carcinoma of the thymus is the most common form of cancer of the thymus. In structure it is similar with peers at other sites and sometimes has a basal cell differentiation (basaloid cancer). It must be differentiated from metastastatic lesions. Lymphoepithelial carcinoma (SYN. limfoepitelioma) is a common tumor of the thymus. She is represented by squamous cell complexes (usually non-keratinizing) or poorly differentiated cancer with marked in varying degrees of lymphocytic infiltration of the stroma. The lymphocytes in this case are not native tumor properties. When a large number of lymphoid cells (especially immature forms) and a small volume of the epithelial component of the tumor should be differentiated from lymphoma. Spindle cancer is rare. It usually includes squamous component. In the absence of the latter, the tumor must be differentiated from sarcoma. Anaplastic cancer is very rare. He harakterizuetsya solid structures, built of highly polymorphic cells. It should be differentiated from metastatic lesions. Mukoèpidermoidnuû cancer consists of two components: squamous and glandular slime. In this case, it is necessary to exclude the metastatic nature of the tumor or growth in the thymus adenocarcinoma of adjacent organs (lung, trachea).
Classification. Existing classifications for practical purposes, the optimal distribution of all malignant tumors of the thymus into 4 phases proposed by Masaoka:
I - the tumor within the thymus, surrounded on all sides by a well-defined capsule-
II - micro - or macroscopic tumor invasion into the capsule of the thymus, adipose tissue in the mediastinum or mediastinal pleura-
III - germination in surrounding organs or other anatomical structures (lung, pericardium, great vessels)-
IVa - dissemination on the pericardium or the pleura and IVб - distant metastases.

Diagnosis of Cancer of the thymus (cancer of the thymus):

Verification of cancer of the thymus based on the use of highly informative diagnostic methods, among which the main place belongs to CT and magnetic resonance imaging. To clarify the histological structure of the tumor is possible to perform mediastinoscopy with the use of individuating. The detection of metastases of cancer of the thymus to other organs is possible by means of scintigraphy with the use of isotropic to tumor radiopharmaceuticals.
Рак вилочковой железы (рак тимуса)
Cancer of the thymus (cancer of the thymus)

ru/" target="_blank">the Treatment of Cancer of the thymus (cancer of the thymus):

Treatment of cancer of the thymus gland and other tumors, surgical. In addition to transactions in the common forms of the disease is chemo - and radiation therapy.
When tumors are surrounded by a capsule (stage I), the optimal longitudinal sternotomy and complete removal of the thymus. It is important to maintain the integrity of the capsule, so it is advisable to remove the thymus gland with the surrounding tissue and the fascia covering the surrounding anatomical structures (mediastinal pleura, vessels, etc.). This technique reduces the probability of leaving a small ectopic sites of the thymus. This expansion of her tumor relapse is casuistry, and therefore no additional radiation therapy is not advocated. Five-year survival rate is 90-95.
Postoperative radiation therapy is indicated in patients with invasive growth of thymoma, especially in lesions of large vessels, pericardium. Local recurrences are observed at different times after surgery 25-30 patients. Radiation therapy in the total tumor dose of 50 Gy in conventional fractionation dose on a "bed" of the tumor and the supraclavicular area reduces the risk of local recurrence in 5-6 times.
Radiation therapy as a standalone treatment option shown in patients with locally advanced common aspects and lesions of the aortic arch or of the myocardium, when its removal is impossible. Five-year survival is only 45-50.
Chemotherapy for generalized forms of Tim-based schemes, including platinum drugs. The most common, the following scheme of chemotherapy: cisplatin 50 mg/m2 intravenously day 1, doxorubicin 40 mg/m2 intravenously day 1, vincristine 0.6 mg/m2 intravenously at day 3, and cyclophosphamide 700 mg/ m2 intravenously on day 4 of the cycle. Repeat treatments every 3 weeks. Just spend 6 courses.
When reasonable doubt in the possibility of radical tumor removal in connection with the possible germination in the large vessels of the mediastinum or heart it is advisable to use induction chemotherapy to reduce tumor size and to create optimal conditions for surgical exposure.
The prognosis of cancer of the thymus worse than thymoma. Three - and five-year survival rate after chemo - and radiotherapy is 40 and 33 respectively.

Which doctors should be consulted if You have Cancer of the thymus (cancer of the thymus):


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