title: Diagnostic features and subtyping of thymoma lymph node metastases.
abstract: OBJECTIVE
  The purpose of the present study was to characterize the morphological features of thymoma metastases in lymph nodes and to evaluate the possibility of their subtyping according to the 2004 WHO classification of thymus tumors.
  
  
  METHODS
  We reviewed 210 thymoma cases in our series of thymic epithelial tumors (TET), including their recurrences and lymphogenous metastases. Three cases of lymph node metastases, one case occurring synchronously with the primary tumor and one synchronously with the first relapse (both in intrathoracic location) and one case of metastasis observed in a laterocervical lymph node subsequently to two thymoma relapses were found.
  
  
  RESULTS
  The metastatic nodes were variably but extensively involved in all cases. The histological features were similar in both primary tumors and metastases. Thymoma metastases were subtyped according to the WHO classification as B3 (one case) and B2 (two cases), and distinctive features in comparison to metastatic epithelial neoplasias from other sites were observed.
  
  
  CONCLUSIONS
  Thymoma lymph node metastases, although rare, can be subtyped according to the WHO classification on the basis of their morphological and immunohistochemical features. Clinically, the presence of nodal metastases may herald subsequent relapses and further metastases even in extrathoracic sites.
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy ; The Pennine Acute Hospitals NHS Trust, Royal Oldham Hospital, Rochdale Road, Oldham, Manchester OL1 2JH, UK.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sioletic
authors.affiliation: Catholic University of Rome, Largo Francesco Vito 1, 00198 Rome, Italy.
authors.forename: Libero
authors.initials: L
authors.lastname: Lauriola
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Enzo
authors.identifier: 0000-0002-4938-4071
authors.initials: E
authors.lastname: Gallo
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Robert
authors.initials: R
authors.lastname: Martucci
authors.affiliation: Department of Neurosciences, Catholic University of Rome, Largo Francesco Vito 1, 00198 Rome, Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Evoli
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, "Federico II" University, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Giovannella
authors.initials: G
authors.lastname: Palmieri
authors.affiliation: Thoracic Surgery, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Melis
authors.affiliation: Radiology , Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Giuseppe
authors.identifier: 0000-0002-6933-4127
authors.initials: G
authors.lastname: Pizzi
authors.affiliation: Medical Oncology "B", Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rinaldi
authors.affiliation: Medical Oncology, S. Eugenio Hospital, P. le dell'Umanesimo 10, 00144 Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lalle
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Pescarmona
authors.affiliation: Division of General Thoracic Surgery, Catholic University of Rome, Largo Francesco Vito 1, 00198 Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
authors.affiliation: Thoracic Surgery, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Facciolo
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
authors.forename: Mirella
authors.identifier: 0000-0002-0045-0234
authors.initials: M
authors.lastname: Marino
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012008:Recurrence; D013945:Thymoma / Q000145:classification* / Q000473:pathology*; D014944:World Health Organization
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