Clinicopathological characteristics of thymic hyperplasia with lymphoepithelial sialadenitis-like features

Wenfeng XU; Lina WANG; Qijian YING; Qingqing HAN; Jiashuang WANG; Deyu GUO

doi:10.16016/j.2097-0927.202311100

您当前的位置：

首页 >

文章列表页 >

Clinicopathological characteristics of thymic hyperplasia with lymphoepithelial sialadenitis-like features

Clinical Medicine | 更新时间：2026-01-09

- Clinicopathological characteristics of thymic hyperplasia with lymphoepithelial sialadenitis-like features
- Journal of Army Medical University Vol. 46, Issue 15, Pages: 1811-1816(2024)
- 作者机构：
  
  550000 贵阳，贵黔国际医院病理科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202311100
  CLC： R322.25;R446.8;R583
- Received：21 November 2023，
  
  Revised：2024-02-04，
  
  Published：15 August 2024
- 稿件说明：
移动端阅览
Wenfeng XU, Lina WANG, Qijian YING, et al. Clinicopathological characteristics of thymic hyperplasia with lymphoepithelial sialadenitis-like features[J]. Journal of Army Medical University, 2024, 46(15): 1811-1816.
DOI：

Wenfeng XU, Lina WANG, Qijian YING, et al. Clinicopathological characteristics of thymic hyperplasia with lymphoepithelial sialadenitis-like features[J]. Journal of Army Medical University, 2024, 46(15): 1811-1816. DOI： 10.16016/j.2097-0927.202311100.

摘要

目的

认识并总结伴淋巴上皮涎腺炎样特征的胸腺增生(thymic hyperplasia with lymphoepithelial sialadenitis-like features，简称LESA样胸腺增生)临床病理特点及鉴别诊断要点，从而减少误诊、漏诊。

方法

收集贵黔国际医院病理科2019年10月1日至2023年9月1日诊断的LESA样胸腺增生病例的临床病理资料，并结合文献复习其流行病学、临床病理特点，以及治疗、预后情况。

结果

纳入2例LESA样胸腺增生女性患者，发病年龄分别为51岁和52岁。影像学上均表现为前纵隔肿物；大体上观测肿块最大径分别为7.5 cm和12.0 cm；镜下及免疫表型显示大量伴有生发中心的淋巴滤泡，滤泡间区见网状或巢状无异型增生的胸腺上皮、胸腺小体以及淋巴上皮病变，局灶可见囊性变、胆固醇结晶及其形成的胆固醇肉芽肿。复习文献报道的LESA样胸腺增生46例，其病理形态及免疫组化表型与本组2例相似，且预后良好，但有5例患者进展为淋巴瘤。

结论

LESA样胸腺增生是一种良性病变，具有独特的病理形态特征，预后良好，但少数患者可进展为淋巴瘤，需要定期密切随访。

Abstract

Objective

To understand and summarize the clinicopathological characteristics and differential diagnosis of lymphoepithelial sialadenitis (LESA)-like thymic hyperplasia.

Methods

The clinicopathological data of patients with LESA-like thymic hyperplasia diagnosed in our hospital from October 1

2019 to September 1

2023 were collected

and the related literatures on their epidemiological characteristics

clinicopathological features

treatments and prognosis were reviewed.

Results

There were 2 female patients with LESA-like thymic hyperplasia included

at an onset age of 51 and 52 years

respectively. Imaging examination revealed an anterior mediastinal mass in both patients

with the largest diameter of 7.5 and 12.0 cm

respectively. Microscopic morphology and immunophenotype analysis showed there were florid lymphoid follicles with germinal centers. Reticular or nested thymic epithelial

thymic corpuscles and lymphoepithelial lesions without dysplasia were seen in the interfollicular areas as well. Focal cystic changes

cholesterol crystals and the formation of cholesterol granuloma were observed. Our results were similar to the pathological morphology and immunohistochemical phenotype of 46 cases with LESA-like thymic hyperplasia reported in the literature. They had favorable prognosis

except 5 patients progressed to lymphoma.

Conclusion

LESA-like thymic hyperplasia is a benign disease with unique morphological characteristics and of favorable prognosis. But rare patients can progress to lymphoma

therefore regular and close follow-up is still required.

关键词

Keywords

references

WEISSFERDT A, MORAN C A. Thymic hyperplasia with lymphoepithelial sialadenitis (LESA)-like features: a clinicopathologic and immunohistochemical study of 4 cases[J]. Am J Clin Pathol, 2012, 138(6): 816-822. DOI: 10.1309/AJCPM6W5MHZMUZRS.

张小鹰, 梅开勇, 王浩, 等. 伴淋巴上皮涎腺炎样特征的胸腺增生临床病理学观察[J]. 诊断病理学杂志, 2021, 28(5): 362-366. DOI: 10.3969/j.issn.1007-8096.2021.05.010.

ZHANG X Y, MEI K Y, WANG H, et al . Thymic hyperplasia with lymphoepithelial sialadenitis-like features: a clinicopathologic and immunohistochemical analysis of two cases[J ] . Chin J Diagn Pathol, 2021, 28(5): 362-366. DOI: 10.3969/j.issn.1007-8096.2021.05.010.

TANAKA N, ISHIHARA S, INOUE M, et al . Thymic hyperplasia with lymphoepithelial sialadenitis-like features arising in a patient with immunoglobulin G4-related disorders: a case report[J ] . Int J Surg Pathol, 2023, 31(6): 1152-1155. DOI: 10.1177/10668969221150530.

PORUBSKY S, POPOVIC Z V, BADVE S, et al . Thymic hyperplasia with lymphoepithelial sialadenitis (LESA)-like features: strong association with lymphomas and non-myasthenic autoimmune diseases[J ] . Cancers(Basel), 2021, 13(2): 315. DOI: 10.3390/cancers13020315.

ARNDT B, GAISER T, MARX A, et al . Lymphoepithelial sialadenitis (LESA)-like thymic hyperplasia: a case report[J ] . Dtsch Med Wochenschr, 2016, 141(14): 1026-1029. DOI: 10.1055/s-0041-109106.

王磊, 蓝松, 彭娟. 淋巴上皮涎腺炎样胸腺增生1例[J]. 诊断病理学杂志, 2023, 30(6): 617-618. DOI: 10.3969/j.issn.1007-8096.2023.06.035.

WANG L, LAN S, PENG J. Lymphepithelial sialadenitis-like thymic hyperplasia: a case report[J]. Chin J Diagn Pathol, 2023, 30(6): 617-618. DOI: 10.3969/j.issn.1007-8096.2023.06.035.

王震, 李海, 曾铮, 等. 胸腺原发黏膜相关淋巴组织淋巴瘤及淋巴上皮性涎腺炎样胸腺增生的临床病理分析[J]. 临床与实验病理学杂志, 2016, 32(12): 1338-1342. DOI: 10.13315/j.cnki.cjcep.2016.12.005.

WANG Z, LI H, ZENG Z, et al . Clinicopathologic study of primary thymic extranodal marginal zone lymphoma of mucosa associated lymphoid tissue and lymphoepithelial sialadenitis-like thymic hyperplasia[J ] . Chin J Clin Exp Pathol, 2016, 32(12): 1338-1342. DOI: 10.13315/j.cnki.cjcep.2016.12.005.

OCAL T, TVRKEN A, CIFTÇI A O, et al . Thymic enlargement in childhood[J ] . Turk J Pediatr, 2000, 42(4): 298-303.

DEEPALI J, JUSTIN A B, MARK R W. Atlas of thymic pathology[M]. Singapore: Springer Nature Singapore Pte Ltd, 2020: 47-55.

WEIS C A, MÄRKL B, SCHUSTER T, et al . True thymic hyperplasia: differential diagnosis of thymic mass lesions in neonates and children[J ] . Pathologe, 2017, 38(4): 286-293. DOI: 10.1007/s00292-017-0283-z.

QU L L, XIONG Y, YAO Q, et al . Micronodular thymoma with lymphoid stroma: two cases, one in a multilocular thymic cyst, and literature review[J ] . Thorac Cancer, 2017, 8(6): 734-740. DOI: 10.1111/1759-7714.12517.

HATANO H, SUMIYA R, MISUMI K, et al . Multilocular thymic cyst detected during COVID-19 treatment in an HIV-positive adult man: a case report and literature review[J ] . Exp Ther Med, 2023, 25(6): 285. DOI: 10.3892/etm.2023.11984.

DAMASKOS C, GARMPIS N, GARMPI A, et al . Multilocular thymic cyst in a young, otherwise healthy woman: a case report[J ] . Cureus, 2020, 12(10): e11210. DOI: 10.7759/cureus.11210.

ADIL ALSINAN T, AHMAD ROBAIDI H, NEAMATALLAH SALEH W. A case report of subclinical myasthenia gravis associated with castleman's disease[J]. Am J Case Rep, 2021, 22: e930948. DOI: 10.12659/AJCR.930948.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Clinical application of CAR-T cells in treatment of hematologic malignancies

Diagnostic value of thoracoscopy for pleural effusion caused by lymphoma

Value of ¹⁸F-FDG PET/CT in diagnosis of lymphoma and lymph node tuberculosis

Treatment and outcomes of extranodal natural killer/T cell lymphoma, nasal type: a retrospective analysis of 85 cases

Interferon-α/β inhibits lymphoma cell proliferation by up-regulating SARI expression

Related Author

Ruihao HUANG

Xi ZHANG

Daishun LIU

Zansheng HUANG

Gang LIU

Yang ZHANG

Yao WANG

Wei LUO

Related Institution

Department of Respiratory Diseases, the Third Affiliated Hospital of Zunyi Medical University

Institute of Respiratory Diseases, Key Laboratory of Respiratory Diseases, Second Affiliated Hospital, Army Medical University (Third Military Medical University)

Hematology Center, First Affiliated Hospital, Army Medical University (Third Military Medical University)

⁰