Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Imaging and Histopathological Features Of Primary Thymic Neuroendocrine Tumor

Author(s): Sushant Suwal, Ying-ying Chen, Sui-dan Huang, Wei-feng Li and Huai Chen*

Volume 20, 2024

Published on: 16 January, 2024

Article ID: e15734056259584 Pages: 8

DOI: 10.2174/0115734056259584231112105510

Price: $65

Abstract

Objectives: To investigate CT, MRI, and PET/CT features with histopathological findings of primary thymic neuroendocrine tumor.

Materials and Methods: All 9 cases with pathologically proven primary thymic neuroendocrine tumors were reviewed retrospectively. Among them, 7 underwent enhanced CT, 1 with MRI (enhanced) and another with PET/CT scan. Multiple characters were examined, including tumor location, contour, CT attenuation, enhancement pattern, involvement of surrounding structure and lymphadenopathy.

Results: Among 9 patients studied, 7 (77%) masses were located in the anterior superior mediastinum, 1 in the anterior superior-middle mediastinum, and 1 in the anterior and middle mediastinum. The maximum diameter (longitudinal) ranged from 4.2 to 23 cm (mean ± standard deviation, 9.5 cm ± 2.8). Four masses had irregular, 3 had lobulated, and 2 had smooth contours, while 8 masses had clear margins and 1 had an ill-defined margin. Six masses showed heterogeneous attenuation with necrotic/cystic component (n=5), calcification (n=2) and hemorrhage(n=1), and 3 showed homogeneous attenuation on the non-enhanced image. After contrast administration, 8 masses showed heterogeneous attenuation, and 1 showed homogeneous attenuation with tumor vessels visible in 4 masses. Among all, 8 masses showed strong enhancement, and 1 showed moderate enhancement in comparison to muscles in the anterior thoracic wall on enhanced images. Involvement of adjacent mediastinal structures was observed in 5 cases. Immunohistochemical analysis showed that the tumor cells were positive for CgA, Syn, CK, CD56 and EMA.

Conclusion: Primary NETs are large masses located anterior superior mediastinum, irregular in contour, showing heterogeneous attenuation with necrotic/cystic component and strong heterogeneous enhancement with tumor vessels, compressing local mediastinal structures. In addition, immunohistochemical examination is required in such a diagnosis.

[1]
Li H, Wang D, Liu X, Geng Z, Xie CM. Computed tomography characterization of neuroendocrine tumors of the thymus can aid identification and treatment. Acta Radiol 2013; 54(2): 175-80.
[http://dx.doi.org/10.1258/ar.2012.120298] [PMID: 23091235]
[2]
Shimamoto A, Ashizawa K, Kido Y, et al. CT and MRI findings of thymic carcinoid. Br J Radiol 2017; 90(1071): 20150341.
[http://dx.doi.org/10.1259/bjr.20150341] [PMID: 28106503]
[3]
Bohnenberger H, Dinter H, König A, Ströbel P. Neuroendocrine tumors of the thymus and mediastinum. J Thorac Dis 2017; 9(S15) (15): S1448-57.
[http://dx.doi.org/10.21037/jtd.2017.02.02] [PMID: 29201448]
[4]
Cardillo G, Treggiari S, Paul MA, et al. Primary neuroendocrine tumours of the thymus: A clinicopathologic and prognostic study in 19 patients. Eur J Cardiothorac Surg 2010; 37(4): 814-8.
[http://dx.doi.org/10.1016/j.ejcts.2009.10.026] [PMID: 19954997]
[5]
Araki T, Sholl LM, Hatabu H, Nishino M. Radiological features and metastatic patterns of thymic neuroendocrine tumours. Clin Radiol 2018; 73(5): 479-84.
[http://dx.doi.org/10.1016/j.crad.2017.11.025] [PMID: 29310810]
[6]
Gaur P, Leary C, Yao JC. Thymic neuroendocrine tumors: A SEER database analysis of 160 patients. Ann Surg 2010; 251(6): 1117-21.
[http://dx.doi.org/10.1097/SLA.0b013e3181dd4ec4] [PMID: 20485130]
[7]
Brcic L, Heidinger M, Popper H. Neuroendokrine neoplasien des mediastinums. Pathologe 2016; 37(5): 434-40.
[http://dx.doi.org/10.1007/s00292-016-0198-0] [PMID: 27507161]
[8]
Filosso PL, Ruffini E, Solidoro P, et al. Neuroendocrine tumors of the thymus. J Thorac Dis 2017; 9(S15) (15): S1484-90.
[http://dx.doi.org/10.21037/jtd.2017.10.83] [PMID: 29201451]
[9]
Ghazi AA, Dezfooli AA, Mohamadi F, et al. Cushing syndrome secondary to a thymic carcinoid tumor due to multiple endocrine neoplasia type 1. Endocr Pract 2011; 17(4): e92-6.
[http://dx.doi.org/10.4158/EP11038.CR] [PMID: 21550948]
[10]
Chaer R, Massad MG, Evans A, Snow NJ, Geha AS. Primary neuroendocrine tumors of the thymus. Ann Thorac Surg 2002; 74(5): 1733-40.
[http://dx.doi.org/10.1016/S0003-4975(02)03547-6] [PMID: 12440652]
[11]
Economopoulos GC, Lewis JW Jr, Lee MW, Silverman NA. Carcinoid tumors of the thymus. Ann Thorac Surg 1990; 50(1): 58-61.
[http://dx.doi.org/10.1016/0003-4975(90)90087-M] [PMID: 2196019]
[12]
Li J, Xia T, Zhang W, He P, Guan Y. Primary small cell neuroendocrine carcinoma of the mediastinum: Computed tomography and histopathological correlation. J Comput Assist Tomogr 2014; 38(2): 174-8.
[http://dx.doi.org/10.1097/RCT.0b013e3182ab21fe] [PMID: 24625609]
[13]
Whitaker D, Dussek J. PET scanning in thymic neuroendocrine tumors. Chest 2004; 125(6): 2368-9.
[http://dx.doi.org/10.1378/chest.125.6.2368-a] [PMID: 15189969]
[14]
Kondo K, Monden Y. Lymphogenous and hematogenous metastasis of thymic epithelial tumors. Ann Thorac Surg 2003; 76(6): 1859-64.
[http://dx.doi.org/10.1016/S0003-4975(03)01017-8] [PMID: 14667600]
[15]
Tiffet O, Nicholson AG, Ladas G, Sheppard MN, Goldstraw P. A clinicopathologic study of 12 neuroendocrine tumors arising in the thymus. Chest 2003; 124(1): 141-6.
[http://dx.doi.org/10.1378/chest.124.1.141] [PMID: 12853516]
[16]
Benveniste MFK, Rosado-de-Christenson ML, Sabloff BS, Moran CA, Swisher SG, Marom EM. Role of imaging in the diagnosis, staging, and treatment of thymoma. Radiographics 2011; 31(7): 1847-61.
[http://dx.doi.org/10.1148/rg.317115505] [PMID: 22084174]
[17]
Yan F, Jin X, Zhang XH, Wu J. Chest CT findings of primary neuroendocrine tumor of thymus:Analysis of 7 cases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2018; 40(4): 468-72.
[http://dx.doi.org/10.3881/j.issn.1000-503X.10365]
[18]
Sadohara J, Fujimoto K, Müller NL, et al. Thymic epithelial tumors: Comparison of CT and MR imaging findings of low-risk thymomas, high-risk thymomas, and thymic carcinomas. Eur J Radiol 2006; 60(1): 70-9.
[http://dx.doi.org/10.1016/j.ejrad.2006.05.003] [PMID: 16766154]
[19]
Uccella S, La Rosa S, Volante M, Papotti M. Immunohistochemical biomarkers of gastrointestinal, pancreatic, pulmonary, and thymic neuroendocrine neoplasms. Endocr Pathol 2018; 29(2): 150-68.
[http://dx.doi.org/10.1007/s12022-018-9522-y] [PMID: 29520563]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy