胸腺瘤的具体分类和诊疗.pptVIP

WHO 2004版胸腺瘤的分类;Histology;CK19;胸腺的免疫染色特点;胸腺肿瘤的概论;A. 儿童时发病率 B. 成年时发病率;Thymoma;Comparison of major histologic classifications of thymoma;临床Masaoka分类;胸腺瘤的分类;Thymoma1,2 1/：为交界性或生物学行为未定肿瘤。 2 ：对于胸腺而言，设定为恶性。 行为编码/1-/3。;2004年胸腺瘤分类的原则;Prognosis;Alberto M. Marchevsky, Ruta Gupta, Robert J. McKenna, et al. Evidence-based Pathology and the Pathologic Evaluation of Thymomas: The World Health Organization Classification Can Be Simplified Into Only 3 Categories Other Than Thymic Carcinoma. Cancer 2008;112:2780–8.;　;Type A;Fig 3.05 A well encapsulated type A thymoma with vaguely lobulated appearance and thin white firous bands.镜下：小叶不清，纤维分隔不明显。;Type A thymoma.A. Spindle cells. B. Oval cells;Type A thymoma. A. Type A thymoma cells can form cysts of various size. B.Type A thymoma cells with haemangiopericytoma-like appearance. C.Rosettes without a lumen. D.Anaplastic malignant cells arising in type A thymoma.;Different histological patterns in type A thymoma. A. Glandular structures. B. Glomeruloid bodies. C. Rosettes with lumens. D. Perivascular spaces.;Type AB;A. Macroscopic appearance of a type AB thymoma showing multiple nodules separated by fibrous bands. B. Type AB thymoma composed of lymphocyte-associated type B nodules and diffuse lymphocyte-poor type A areas.;Type AB thymoma. A. The lymphocyte-associated type B component and the lymphocyte-poor type A component intermix together. The type A component cells appear as elongated fibroblast-like spindle cells. B. The type B component of predominantly small polygonal cells with small round or oval pale nuclei with pale chromatin and inconspicuous nucleoli. C. Type A component is poor in lymphcytes(left), while type B component is lymphocyte-rich (right).同一肿瘤中二者的混合不同部位，表现不同，可互相交织或截然分开。;Type B1;Type B1 thymoma. A. Medullary island(MI) showing Hassall’s corpuscles. The abnormal localization of MI adjacent to septa or the tumor capsule is wery typical. B. High-power of cortex-like areas in B1 thymoma showing a vast majority