title: Patients with thymomas have an increased risk of developing additional malignancies: lack of immunological surveillance?
abstract: OBJECTIVE
  To assess the risk, for patients with thymoma, of developing an additional malignancy (AM).
  
  
  RESULTS
  We studied 68 patients with thymomas. Based on the World Health Organization classification, the tumours were categorised as A, AB or B (B1, B2, B3) thymomas. Control populations comprised 114 patients with colorectal cancer, 108 patients with lymphoma and 123 patients with thyroid carcinoma. Patients with thymomas showed a higher risk of developing an AM (22 of 68 patients versus 11 of 114, eight of 108, and eight of 123 patients, respectively; P = 0.0002). The association between thymomas and AMs was related to the thymoma histotype, with B1, B2, B3 and AB tumours showing a higher risk of developing an AM than A thymomas (P = 0.0474).
  
  
  CONCLUSIONS
  Patients affected by thymomas showed a significantly higher risk of developing additional malignancies than those in the control groups, and cases that exhibited a predominantly cortical component were more likely to develop other neoplasms. This may be related to the functions of cortical thymic epithelial cells in providing for T lymphocyte maturation through interaction with major histocompatibility complexes.
authors.affiliation: Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Surgery, Siena University Hospital, Siena, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Granato
authors.forename: Maria R
authors.initials: MR
authors.lastname: Ambrosio
authors.forename: Donatella
authors.initials: D
authors.lastname: Spina
authors.forename: Stefano
authors.initials: S
authors.lastname: Lazzi
authors.forename: Bruno J
authors.initials: BJ
authors.lastname: Rocca
authors.forename: Luca
authors.initials: L
authors.lastname: Voltolini
authors.forename: Stefano
authors.initials: S
authors.lastname: Bongiolatti
authors.forename: Luca
authors.initials: L
authors.lastname: Luzzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gotti
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Leoncini
authors.forename: Piero
authors.initials: P
authors.lastname: Tosi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007157:Immunologic Surveillance / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000276:immunology*; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology; D013945:Thymoma / Q000276:immunology* / Q000473:pathology; D013953:Thymus Neoplasms / Q000276:immunology* / Q000473:pathology; D055815:Young Adult