CASE IS OPEN FOR DISCUSSION:
75 yrs old male with resected mediastinal mass.
MACRO: Fatty tissue piece of 6x4,5x2 cm. Lobated greyish tumor with defined margins 2,5x2x2 cm with yellowish cyst 1,2x1x0,6 cm. 4 lymph nodes up to 0,5 cm found.
HISTO: fat tissue with "tumor":
- Lymphoid stroma with II lymphoid follicles (without TdT+ lymphoblasts) and epithelial proliferation (cysts, strands, serpantines);
- Cysts with hyalinised walls and papillary epithelial formations;
- 1 lymphoid nodule within cyst with epithelial diffuse network (block 3).
- Thymus residual nests with TdT+ cells at periphery and 4 reactive nodes (not included).
PROPOSAL:
Thymic Hyperplasia With Lymphoepithelial Sialadenitis (LESA)–like Features with multilocular thymic cyst.
Reactive lymphadenopathy (4).
QUESTION:
Single nodule with diffuse PanCK+ network within cyst avoiding TdT+ lymphobblasts (thymoma B like).
LITERATURE:
Weissferdt A, Moran CA. Thymic hyperplasia with lymphoepithelial sialadenitis (LESA)-like features: a clinicopathologic and immunohistochemical study of 4 cases. Am J Clin Pathol. 2012;138(6):816-822.