Thymoma CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]

Overview

The tumor is generally located inside the thymus, and can be calcified. Increased vascular enhancement can be indicative of malignancy, as can be pleural deposits.

CT Scan

When a thymic mass is identified, the made is achieved with histology (obtaining a tissue sample of the mass). When a thymoma is suspected, a CT/CAT scan is generally performed to estimate the size of the tumor, and can be biopsied with a CT-guided needle. There is a small risk of pneumomediastinum, mediastinitis and the risk of damaging the heart or large blood vessels. The final diagnosis is made by removing the thymus. Pathological investigation of the specimen will reveal if the tumor was benign or malignant, although the initial biopsy is usually indicative.[1]

Biopsy

CT-guided core needle biopsy or CT-guided fine needle-aspiration (FNA) should be done to confirm the histological classification and the diagnosis. CT-guided FNA has higher sensitivity and specificity and also less side effects than the core needle biopsy, but it has lower chances of differentiating between thymoma and thymic carcinoma which is important for the appropriate management plan. If both modalities failed to obtain the accurate diagnosis, mediastinoscopy, videothoracoscopy (VATS) or a diagnostic and therapeutic en bloc thymectomy might be considered.[2][2]

[3]


References

  1. Thomas CR, Wright CD, Loehrer PJ (1999). "Thymoma: state of the art". Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 17 (7): 2280–9. PMID 10561285. Retrieved 2012-01-18. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 "Percutaneous needle biopsy of the mediastinum: review of 94 procedures".
  3. "thymoma". Text " Search " ignored (help); Text " Radiopaedia.org " ignored (help)


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