Journal
VIRCHOWS ARCHIV
Volume 479, Issue 1, Pages 215-220Publisher
SPRINGER
DOI: 10.1007/s00428-021-03125-2
Keywords
Multilocular thymic cyst; Mediastinal seminoma; Myoid cells; Thymic tuft cells
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Multilocular thymic cyst (MTC) and germ cell tumors are common mediastinal diseases that can be challenging to correctly diagnose due to potential mimics. A case study of a male patient with both MTC and mediastinal seminoma highlights the significance of recognizing histological features and reveals novel findings in MTC pathogenesis.
Multilocular thymic cyst (MTC) and germ cell tumors are common diseases that impact the mediastinum. Correctly diagnosing these diseases can be difficult because several other conditions can mimic them. We report a male patient with MTC associated with mediastinal seminoma. A needle biopsy of the mediastinal tumor revealed numerous epithelioid cell granulomas that mimicked sarcoidosis or mycobacterial infection. However, large atypical cells positive for Oct3/4 and KIT were noted between the granulomas; thus, we diagnosed the patient with mediastinal seminoma. The resected tumor, after chemotherapy, consisted of multiple cystic lesions, and a residual germ cell tumor was first considered. However, thymic medulla-specific elements, namely, POU2F3-positive thymic tuft cells and rhabdomyomatous myoid cells accompanying the epithelium, led to the correct diagnosis of MTC. Our case underscores the importance of recognizing the histological features associated with mediastinal seminoma and provides novel findings for MTC pathogenesis, namely, the presence of thymic tuft cells.
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