Atlas of Mediastinal Pathology by Saul Suster

By Saul Suster

The mediastinum is a digital compartment within the chest hollow space that's the seat of numerous very important organs and constructions that may be all in favour of quite a few pathologic techniques, together with congenital and developmental abnormalities, inflammatory stipulations, and benign and malignant neoplasms. The Atlas of Mediastinal Pathology offers a pictorial survey of the most important ailment techniques that could have an effect on this anatomic compartment, together with congenital and bought cysts, benign hamartomatous methods, inflammatory tactics regarding the mediastinum, and benign and malignant neoplasms. The latter comprises tumors of the thymus (thymoma and thymic carcinoma), neuroendocrine neoplasms, germ mobile tumors, mesenchymal neoplasms, and hematolymphoid malignancies. using ancillary diagnostic tools is illustrated, the place acceptable, supplying suggestions for pathologists in arriving on the right analysis.

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1 Thymomas Fig. 28 A spindle-cell thymoma with a hemangiopericytoma-like growth pattern is characterized by multiple branching vascular spaces with open lumina surrounded by a dense spindle-cell population. On cursory examination, tumors with these features can be mistaken for solitary fibrous tumors or monophasic synovial sarcomas Fig. 29 A different appearance of spindle-cell thymoma with a hemangiopericytoma-like growth pattern shows dilated, anastomosing, and branching vascular spaces lined by round to oval cells simulating hemangiopericytoma 27 Fig.

A large number of histologic variants have been described, some of which have shown a tendency to be associated with secondary cystic changes such as basaloid and mucoepidermoid carcinoma. The diagnosis of thymic carcinoma is, in general, a diagnosis of exclusion, since there is very little that is distinctive or pathognomonic about these tumors other than their location in the mediastinum. Morphologically, it can be very difficult to separate them from similar cancers occurring at other organs.

112 Clear cell carcinoma of the thymus can sometimes be the result of secondary clear cell changes in well-differentiated squamous cell carcinoma caused by intracytoplasmic accumulation of glycogen Fig. 114 Higher magnification of basaloid carcinoma of the thymus shows small, oval, and spindle cells with hyperchromatic nuclei and an inconspicuous rim of cytoplasm. The tumors are very cellular and display high mitotic activity and apoptosis. Notice the prominent peripheral palisading of cells at the borders of the tumor cell islands Fig.

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