Clonality analysis performed using human androgen receptor assay in a rare case of undifferentiated thymic carcinoma coexisting with type AB thymoma.

Abstract:

:We report a very rare case of combined thymic carcinomas: undifferentiated thymic carcinoma coexisting with type AB thymoma. The precise mechanism underlying the coexistence of these tumors remains unknown. Therefore, we used clonality analysis to ascertain whether the two tumors were clonally related. A 63-year-old woman with thyroid cancer visited our hospital. Chest computed tomography also revealed an anterior mediastinal tumor. The patient was treated with total thyroidectomy and surgery for mediastinal tumors together with left upper lobe partial resection. The mediastinal tumor was pathologically diagnosed as undifferentiated thymic carcinoma coexisting with type AB thymoma. Multiple pulmonary metastases were detected in the patient and stage IV disease was diagnosed. The tumor was treatment-resistant, and the patient received fourth-line chemotherapy. We conducted clonality analysis using an improved human androgen receptor gene-amplification assay that involves random X-chromosome inactivation through methylation, followed by methylated gene-specific PCR amplification after sample DNA digestion with HpaII, a methylation-sensitive restriction enzyme. Clonality analysis demonstrated identical X-chromosome inactivation in cells present in both thymoma and thymic carcinoma areas, and thus revealed clonal proliferation. The two lesions in the patient might have arisen through the transformation of a preexisting thymoma into a more malignant lesion.

journal_name

Pathol Int

journal_title

Pathology international

authors

Karino F,Yokose T,Matsukuma S,Miyagi Y,Murakami S,Ito H,Nakayama H,Yamada K

doi

10.1111/pin.12426

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

398-403

issue

7

eissn

1320-5463

issn

1440-1827

journal_volume

66

pub_type

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