Differential diagnosis of thymic hyperplasia and mediastinal tumor in patients with Hodgkin's lymphoma after chemotherapy

Abstract


Aim. To make differential diagnosis of thymic hyperplasia and mediastinal tumor after chemotherapy (CT) in patients with Hodgkin's disease (HD).
Material and methods. The examination of 182 HD patients aged 16-71 years (median 28 years) included chest x-ray computed tomography (XCT) at baseline, during treatment, each 3 months, ultrasound investigation of the chest and abdominal cavity. All the patients received 6-8 courses of the treatment according to the program BEACOPP-14 followed by radiotherapy on the residual tumor in 137 patients, or not followed in 45 patients.
Results. Soft tissue tumor in the anterior mediastinum was detected in 14 (31%) from 45 unirradiated patients (age 19-31 years, median 24 years) 1 to 10 months (median 3.5 months) after chemotherapy. The analysis of the data of ultrasound investigation and tomography identified a mediastinal lesion as thymic hyperplasia. The patients are now in remission with follow-up median 21 months (13-36 months). No recurrence was registered.
Conclusion. Young HD patients with unirradiated mediastinum develop thymic hyperplasia in 31% cases within one year after chemotherapy. In view of this, detection of the lesion in the anterior mediastinum after CT demands complex examination for differential diagnosis of thymic hyperplasia with tumor recurrence to avoid unwanted intensification of the treatment.

About the authors

Tat'yana Nikolaevna Moiseeva

Email: taniamoiseeva@mail.ru

Lyubov' Sattarovna Al'-Radi

Email: alradi@blood.ru

Irina Vadimovna Shitareva

Aleksandr Abramovich Shevelev

Email: asw_99@mail.ru

Irina Eduardovna Kostina

Email: ikost@list.ru

S K Kravchenko

Email: krav@blood.ru

A M Kremenetskaya

N N Tsyba

Email: tsyba@blood.ru

T N Moiseeva

Hematological Research Center, Moscow

Hematological Research Center, Moscow

L S Al-Radi

Hematological Research Center, Moscow

Hematological Research Center, Moscow

I V Shitareva

Hematological Research Center, Moscow

Hematological Research Center, Moscow

A A Shevelev

Hematological Research Center, Moscow

Hematological Research Center, Moscow

I E Kostina

Hematological Research Center, Moscow

Hematological Research Center, Moscow

S K Kravchenko

Hematological Research Center, Moscow

Hematological Research Center, Moscow

A M Kremenetskaya

Hematological Research Center, Moscow

Hematological Research Center, Moscow

N N Tsyba

Hematological Research Center, Moscow

Hematological Research Center, Moscow

References

  1. Castleman В. Tumors of the thymus gland. In: Atlas of tumor pathology. Fasc. l9: Armed forces Institute of Pathology. Washington; 1955.
  2. Rosai J., Levine G. Tumors of the thymus. In: Atlas of tumor pathology. Fasc. 13. Armed forces Institute of Pathology. Washington; 1976.
  3. Goldstein G. Thymitis and myasthenia gravis. Lancet 1996; 2: 1164-1167.
  4. Gelfand D. W., Goldman A. C., Law E. J. et al. Thymic hyperplasia in children recovering from thermal burns. J. Trauma 1972; 12: 813-817.
  5. Rizk G., Gueto L., Amplatz K. et al. Rebound enlargement of the thymus after successful corrective surgery for transpositions of the great vessels. Am. J. Roentgenol. 1972; 116: 528-530.
  6. Maiorana A., Reggiani-Bonetti L. Hyperplastic and inflammatory pathology of the thymus. In: Thymus gland pathology - clinical, diagnostic and therapeutic features. Springer-Verlag; Italia. 2008. 39-67.
  7. Choyke P. L., Zeman R. K., Gootenberg J. E. et al. Thymic athrofy and regrouth in response to chemotherapy: CT evaluation. Am. J. Roentgenol. 1987; 149: 269-272.
  8. Kissin S. M., Husband J. E., Nicholas D. et al. Begin thymic enlargement in adults after chemotherapy: CT demonstration. Radiology 1987; 163: 67-70.
  9. Rüther U., Müller H. A., Nunnensiek C. et al. Thymic hyperplasia in patients with malignant testicular tumors. Med. Clin. (Münich) 1990; 85: 72-77.
  10. Null J. A., Livolsi V. A., Glenn W. W. Hodgkin's disease of the thymus (granulomatous thymoma) and myasthenia gravis: a unique association. Am. J. Clin. Pathol. 1977; 67(6): 521-525.
  11. Katz A., Lattes R. Granulomatous thymoma or Hodgkin's disease of the thymus? A clinical and histologic study and a reevaluation. Cancer 1969; 23(1): 1-15.
  12. Nemoto K., Ishikawa H., Ohnishi Y. et al. Hodgkin's disease accompanied with thymoma. Acta Pathol. Jpn 1987; 37(9): 1505-1512.
  13. Hermann R., Greminger P., Dommann-Scherrer C. et al. Diffuse thymus hyperplasia following chemotherapy for nodular sclerosing Hodgkin lymphoma. Schweiz. Med. Wschr. 1994; 124(38): 1666-1671.
  14. Zhen Z. J., Sun X. F., Xia Y. et al. Clinical analysis of reactive thymic hyperplasia following chemotherapy for childhood malignant lymphoma. Ai Zheng 2006; 25(4):471-475.
  15. Zhen Z. J., Sun X. F., Xia Y. et al. Clinical analysis of thymic regrowth following chemotherapy in children and adolescents with malignant lymphoma. Jpn J. Clin. Oncol. 2010; 40(12): 1128-1134.
  16. Wernecke K., Diederich S. Sonographic features of mediastinal tumors. Am. J. Roentgenol. 1994; 163: 1357-1364.
  17. Shevelev A. A., Moiseeva T. N. Role of ultrasonography (US) in differential diagnosis of mediastinal mass enlargement after therapy of patients with advanced stages of Hodgkin disease (HD) treated by BEACOPP-14 cycles without subsequent irradiation. Haematologica 2010; 95(s4): 47.

Statistics

Views

Abstract - 140

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2020 Moiseeva T.N., Al'-Radi L.S., Shitareva I.V., Shevelev A.A., Kostina I.E., Kravchenko S.K., Kremenetskaya A.M., Tsyba N.N., Moiseeva T.N., Al-Radi L.S., Shitareva I.V., Shevelev A.A., Kostina I.E., Kravchenko S.K., Kremenetskaya A.M., Tsyba N.N.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:

 

© 2018 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies