Abstract:
:Pathologic diagnosis of thymic tumors (TTs) can be made by surgical or nonsurgical procedures. About 20% of TTs had been diagnosed by pretreatment biopsy methods while the rest had gone to surgery for diagnosis and treatment. However, in the last two decades there was an increase in pretreatment procedures for optimal management of locally advanced or metastatic TTs. Pretreatment tissue diagnosis of a noninvasive TT is not a standard option but is required if there is suspect or atypical clinical presentation and imaging, an invasive tumor requiring a nonsurgical approach or preoperative chemotherapy or chemo-radiotherapy, strong possibility of lymphoma or unclear differential diagnosis between lymphoma or other solid tumor by imaging studies, or suspicion of a metastatic lesion. In surgical diagnosis anterior mediastinotomy, video-assisted thoracic surgery or mediastinoscopy can be chosen for invasive TTs whereas total resection is performed for small, noninvasive tumors. Nonsurgical diagnosis can be made by transthoracic fine or core needle biopsies (TTFNA, TTCNB), conventional bronchoscopy, endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) or medical thoracoscopy depending on procedural amenability according to tumor extension. TTFNA and TTCNB have been the most frequently used nonsurgical methods. However, there is an upward trend in using conventional bronchoscopy, EBUS-TBNA, EUS-FNA and medical thoracoscopy recently. To increase the diagnostic performance of these procedures in TTs, recommendations are (I) obtaining histologic specimens, (II) combining smears or liquid based cytology preparations and cell blocks, (III) obtaining multiple sufficient samples, (IV) combining histologic and cytologic specimens, (V) performing morphologic, immunohistochemical and molecular analyses on all specimens, (VI) using rapid onsite evaluation for cytologic specimens, (VII) correlating pathologic, clinical and radiologic findings, (VIII) consulting experienced pathologists.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Bilaçeroğlu Sdoi
10.21037/jtd-2019-thym-14subject
Has Abstractpub_date
2020-12-01 00:00:00pages
7598-7606issue
12eissn
2072-1439issn
2077-6624pii
jtd-12-12-7598journal_volume
12pub_type
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.10.28
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abstract::[This corrects the article on p. E83 in vol. 8, PMID: 26904259.]. ...
journal_title:Journal of thoracic disease
pub_type: 已发布勘误
doi:10.21037/jtd.2016.09.33
更新日期:2016-09-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.03.173
更新日期:2017-07-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.76
更新日期:2018-06-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2013.11.15
更新日期:2013-12-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.123
更新日期:2018-04-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.03.82
更新日期:2016-04-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.21037/jtd.2018.06.108
更新日期:2018-07-01 00:00:00
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pub_type: 杂志文章
doi:10.21037/jtd-19-3887
更新日期:2020-07-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.04.08
更新日期:2018-04-01 00:00:00