{"content":[{"text":"Thymic Tumors","bbox":{"left":0.040933,"top":0.012722,"width":0.208364,"height":0.025000000000000005}},{"text":"Thymoma","bbox":{"left":0.033511,"top":0.053417,"width":0.135,"height":0.025}},{"text":"Thymic epithelial neoplasms with a variety of histologic patterns. \n Overall rare, but most common mediastinal tumor in adults.","bbox":{"left":0.198796,"top":0.055736,"width":0.599517,"height":0.034666999999999996}},{"text":"Multiple subclassifications (see below), but stage is much more important prognostically! \n (All subtypes can behave aggressively or indolently, mostly important to aid in recognition and DDX)","bbox":{"left":0.013333,"top":0.099833,"width":0.896339,"height":0.034667}},{"text":"Frequent association with paraneoplastic syndromes: \n Most common = Myasthenia gravis (autoantibodies block acetylcholine receptors between muscle & \n nerves → weakness) \n Other syndromes: Collagen and autoimmune disorders (e.g., lupus), immunodeficiencies, endocrine \n disorders, dermatologic disorders, enterocolitis, etc..","bbox":{"left":0.013333,"top":0.144833,"width":0.9094399999999999,"height":0.08869500000000002}},{"text":"Type","bbox":{"left":0.033022,"top":0.245569,"width":0.049881,"height":0.018833000000000016}},{"text":"Composition","bbox":{"left":0.205296,"top":0.245569,"width":0.13232599999999997,"height":0.018833000000000016}},{"text":"Proportion \n Epithelium","bbox":{"left":0.527741,"top":0.245569,"width":0.11323799999999995,"height":0.04133299999999998}},{"text":"Proportion \n Lymphocytes","bbox":{"left":0.685426,"top":0.245569,"width":0.135749,"height":0.04133299999999998}},{"text":"Prognosis","bbox":{"left":0.848481,"top":0.245569,"width":0.10064300000000004,"height":0.018833000000000016}},{"text":"Type A","bbox":{"left":0.033022,"top":0.300736,"width":0.07264300000000001,"height":0.019500000000000017}},{"text":"Bland spindled to ovoid cells, few \n or no admixed lymphocytes","bbox":{"left":0.205296,"top":0.300028,"width":0.274995,"height":0.033665999999999974}},{"text":"Predominant, \n spindled/oval","bbox":{"left":0.527741,"top":0.300028,"width":0.11325200000000002,"height":0.033665999999999974}},{"text":"Few/none","bbox":{"left":0.685426,"top":0.300028,"width":0.08459000000000005,"height":0.015332999999999986}},{"text":"Excellent","bbox":{"left":0.848481,"top":0.300028,"width":0.07488700000000004,"height":0.015332999999999986}},{"text":"Type AB","bbox":{"left":0.033022,"top":0.352542,"width":0.08721799999999999,"height":0.019500000000000017}},{"text":"Both lymphocyte poor (type A) and \n lymphocyte-rich (type B) \n components, with a significant \n proportion of immature T cells","bbox":{"left":0.205296,"top":0.351833,"width":0.29042100000000004,"height":0.07033299999999998}},{"text":"Significant","bbox":{"left":0.527741,"top":0.351833,"width":0.08574300000000001,"height":0.015332999999999986}},{"text":"Significant","bbox":{"left":0.685426,"top":0.351833,"width":0.08574300000000001,"height":0.015332999999999986}},{"text":"Very good","bbox":{"left":0.848481,"top":0.351833,"width":0.08491399999999993,"height":0.015332999999999986}},{"text":"Type B1","bbox":{"left":0.033022,"top":0.435875,"width":0.084704,"height":0.019500000000000017}},{"text":"Predominantly lymphocytes with \n dispersed epithelial cells (that do \n not form clusters)","bbox":{"left":0.205296,"top":0.435167,"width":0.27230699999999997,"height":0.05199899999999996}},{"text":"Low, no \n clusters, \n polygonal","bbox":{"left":0.527741,"top":0.435167,"width":0.08113400000000004,"height":0.05199899999999996}},{"text":"Predominant","bbox":{"left":0.685426,"top":0.435167,"width":0.10833400000000004,"height":0.015332999999999986}},{"text":"Very good","bbox":{"left":0.848481,"top":0.435167,"width":0.08491399999999993,"height":0.015332999999999986}},{"text":"Type B2","bbox":{"left":0.033022,"top":0.500903,"width":0.084704,"height":0.019499999999999962}},{"text":"Predominantly lymphocytes, with \n small clusters of epithelial cells","bbox":{"left":0.205296,"top":0.500142,"width":0.277366,"height":0.033719000000000054}},{"text":"Low, small \n clusters","bbox":{"left":0.527741,"top":0.500142,"width":0.08708699999999991,"height":0.033719000000000054}},{"text":"Significant","bbox":{"left":0.685426,"top":0.500142,"width":0.08576600000000001,"height":0.01536700000000002}},{"text":"Fair","bbox":{"left":0.848481,"top":0.500142,"width":0.030931000000000042,"height":0.01536700000000002}},{"text":"Type B3","bbox":{"left":0.033022,"top":0.552681,"width":0.084704,"height":0.019499999999999962}},{"text":"Predominantly atypical polygonal \n epithelial cells in sheets.","bbox":{"left":0.205296,"top":0.551972,"width":0.27572399999999997,"height":0.033667}},{"text":"Predominant, \n epithelioid","bbox":{"left":0.527741,"top":0.551972,"width":0.11325200000000002,"height":0.033667}},{"text":"Few","bbox":{"left":0.685426,"top":0.551972,"width":0.03417999999999999,"height":0.015333000000000041}},{"text":"Fair, often \n high stage","bbox":{"left":0.848481,"top":0.551972,"width":0.08536399999999988,"height":0.033667}},{"text":"Micronodular \n with lymphoid \n stroma","bbox":{"left":0.033022,"top":0.604097,"width":0.134214,"height":0.05666700000000002}},{"text":"Multiple small tumors with bland \n spindled cells surrounded by \n lymphoid stroma","bbox":{"left":0.205296,"top":0.603764,"width":0.2733709999999999,"height":0.052000000000000046}},{"text":"Significant, \n spindled","bbox":{"left":0.527741,"top":0.603764,"width":0.09084499999999995,"height":0.033666000000000085}},{"text":"Significant. B & \n T cells, without \n epithelial cells","bbox":{"left":0.685426,"top":0.603764,"width":0.12546599999999997,"height":0.052000000000000046}},{"text":"Excellent","bbox":{"left":0.848481,"top":0.603764,"width":0.07488700000000004,"height":0.015333000000000041}},{"text":"Metaplastic","bbox":{"left":0.033022,"top":0.674097,"width":0.108343,"height":0.016666999999999987}},{"text":"Biphasic tumor consists of solid \n polygonal epithelial cells in a \n background of bland spindled cells","bbox":{"left":0.205296,"top":0.673764,"width":0.285346,"height":0.052000000000000046}},{"text":"Predominant, \n epithelioid and \n spindled","bbox":{"left":0.527741,"top":0.673764,"width":0.12406499999999998,"height":0.052000000000000046}},{"text":"Few/none","bbox":{"left":0.685426,"top":0.673764,"width":0.08459000000000005,"height":0.015333000000000041}},{"text":"Very good","bbox":{"left":0.848481,"top":0.673764,"width":0.08491399999999993,"height":0.015333000000000041}},{"text":"Subtyping: \n Some thymomas are heterogeneous and show multiple patterns of growth. In these cases, list the \n different patterns quantified by %. Also, be careful definitely subtyping a thymoma on a limited \n sampling (likely best to just Dx as “Thymoma” and give the pattern(s) present in the biopsy).","bbox":{"left":0.028267,"top":0.745764,"width":0.8806569999999999,"height":0.07667500000000005}},{"text":"Note: Type AB thymomas are inherently heterogeneous.","bbox":{"left":0.028267,"top":0.832472,"width":0.5067429999999999,"height":0.016666999999999987}},{"text":"Immunohistochemistry: \n Most do not require IHC for subtyping. Often used to differentiate from Non-thymomas. \n Thymic epithelial cells → AE1/AE3, p63, PAX8. \n T-Cells in thymus → CD5, CD3, TdT (immature thymic T-cells)","bbox":{"left":0.028267,"top":0.8708,"width":0.7921279999999999,"height":0.07666699999999993}}],"images_bbox":[],"images_bbox_not_text_overlap":[]}