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Micronodular thymic carcinoma with lymphoid hyperplasia: relevance of immunohistochemistry with a small panel of antibodies for diagnosis: a RYTHMIC study

Micronodular thymic carcinoma with lymphoid hyperplasia (MNTCLH) is a rare form of thymic carcinoma. We present the experience of RYTHMIC, the French national network devoted to the treatment of thymic epithelial tumors through multidisciplinary tumor boards with a review of all tumors by pathologis...

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Main Authors: Thomas de Montpréville, Vincent (Author) , Mansuet-Lupo, Audrey (Author) , Le Naoures, Cécile (Author) , Chalabreysse, Lara (Author) , De Muret, Anne (Author) , Hofman, Véronique (Author) , Rouquette, Isabelle (Author) , Piton, Nicolas (Author) , Dubois, Romain (Author) , Benitez, Jose Carlos (Author) , Girard, Nicolas (Author) , Besse, Benjamin (Author) , Marx, Alexander (Author) , Molina, Thierry Jo (Author)
Format: Article (Journal)
Language:English
Published: October 2021
In: Virchows Archiv
Year: 2021, Volume: 479, Issue: 4, Pages: 741-746
ISSN:1432-2307
DOI:10.1007/s00428-021-03044-2
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s00428-021-03044-2
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Author Notes:Vincent Thomas de Montpreville, Audrey Mansuet-Lupo, Cécile Le Naoures, Lara Chalabreysse, Anne De Muret, Véronique Hofman, Isabelle Rouquette, Nicolas Piton, Romain Dubois, Jose Carlos Benitez, Nicolas Girard, Benjamin Besse, Alexander Marx, Thierry Jo Molina
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Summary:Micronodular thymic carcinoma with lymphoid hyperplasia (MNTCLH) is a rare form of thymic carcinoma. We present the experience of RYTHMIC, the French national network devoted to the treatment of thymic epithelial tumors through multidisciplinary tumor boards with a review of all tumors by pathologists for classification and staging. Six cases of MNTCLH were diagnosed during a review of 1007 thymic epithelial tumors. Histologically, epithelial cells with atypia and mitoses formed micronodules that were surrounded by an abundant lymphoid background with follicles. There was neither obvious fibro-inflammatory stroma nor necrosis. Spindle cells areas were common. Initial diagnosis was micronodular thymoma in two cases, cellular atypia being overlooked, eclipsed by the micronodular pattern. Immunohistochemistry with a panel of five antibodies showed that cytokeratins (AE1-AE3) and p63-positive epithelial cells also expressed CD5 and that there was no TdT-positive cells within the tumors. CD20 highlighted the lymphoid hyperplasia. Additionally epithelial cells also expressed CD117 and diffusely Glut 1. Twenty-seven micronodular thymomas with lymphoid stroma diagnosed during the same period did not show the CD5 and CD117 positivities seen in MNTCLH and contained TdT-positive lymphocytes. Three of the 6 patients with MNTCLH had adjuvant radiotherapy. Three patients with follow-up information were alive without recurrence at 38, 51, and 95 months. Our study shows that immunohistochemistry, such as that used in the RYTHMIC network with a small panel of antibodies, may easily help to confirm the correct diagnosis of MNTCLH, a rare and low-aggressive form of thymic carcinoma, and avoid the misdiagnosis of micronodular thymoma.
Item Description:Published: 24 February 2021
Gesehen am 14.09.2023
Physical Description:Online Resource
ISSN:1432-2307
DOI:10.1007/s00428-021-03044-2

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