Frontiers in surgery · 2026
Combined immunohistochemistry and FISH testing for diagnosing metaplastic thymoma: a case report of misdiagnosis as pulmonary mucinous epidermoid carcinoma.
СтатьяНазвание и аннотация: Перевод в очереди
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Liu Jiaxin, Yu Xiang, Li Wenquan, Shen Chunhui, Wang Zhenhui, Wang Jiyong
Аннотация
SIMPLE SUMMARY: Differentiating metaplastic thymoma from pulmonary mucoepidermoid carcinoma through immunohistochemistry and FISH testing provides diagnostic evidence for clinical practice. This study investigates the clinical-pathological features, immunophenotype, and di agnostic criteria of metaplastic thymoma (MT), distinguishing it from pulmonary mucinous epidermoid carcinoma (PEMC).
METHODS: Clinical data from a single patient with surgically confirmed metaplastic thymoma were collected. Histological examination, immunohistochemical staining, and molecular testing were performed.
RESULTS: The patient was a middle-aged woman. Postoperative pathological immunohistochemistry revealed a tumor composed of relatively benign epithelioid and spindle cells. Epithelioid cells exhibited nests with mildly enlarged nuclei and rare mitotic figures, accompanied by focal degenerative necrosis. Immunohistochemistry results: CD117 (-), CD20 (-), CD3 (speckled +), CD34 (-), CD5 (speckled +), CD99 (-), CK20 (-), CK7 (partial +), EMA (spindle cells +; epithelioid cells speckled perinuclearly +), Ki67 (5%+), P53 (80%+), P63 (+), Syn (-), TDT (-). Molecular testing: YAP1-MAML2 gene break-up rearrangement detected.
CONCLUSION: Metaplastic thymoma represents a rare subtype of thymoma. Diagnosis requires integration of clinical presentation, microscopic morphology, immunohistochemical features, and molecular biology data to enhance diagnostic accuracy and facilitate effective differentiation from pulmonary mucinous epidermoid carcinoma.
METHODS: Clinical data from a single patient with surgically confirmed metaplastic thymoma were collected. Histological examination, immunohistochemical staining, and molecular testing were performed.
RESULTS: The patient was a middle-aged woman. Postoperative pathological immunohistochemistry revealed a tumor composed of relatively benign epithelioid and spindle cells. Epithelioid cells exhibited nests with mildly enlarged nuclei and rare mitotic figures, accompanied by focal degenerative necrosis. Immunohistochemistry results: CD117 (-), CD20 (-), CD3 (speckled +), CD34 (-), CD5 (speckled +), CD99 (-), CK20 (-), CK7 (partial +), EMA (spindle cells +; epithelioid cells speckled perinuclearly +), Ki67 (5%+), P53 (80%+), P63 (+), Syn (-), TDT (-). Molecular testing: YAP1-MAML2 gene break-up rearrangement detected.
CONCLUSION: Metaplastic thymoma represents a rare subtype of thymoma. Diagnosis requires integration of clinical presentation, microscopic morphology, immunohistochemical features, and molecular biology data to enhance diagnostic accuracy and facilitate effective differentiation from pulmonary mucinous epidermoid carcinoma.