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WHO types A and AB thymomas: not always benign Jain RK; Mehta RJ; Henley JD; Kesler KA; Loehrer PJ; Badve SMod Pathol 2010[Dec]; 23 (12): 1641-9The 2004 WHO classification of thymic tumors recognizes five major subtypes of thymomas and thymic carcinoma. Subtypes A and AB thymomas are purported to be benign neoplasms, although prior studies have suggested a potential for malignant behavior. The purpose of this study was to assess the clinical behavior of A and AB thymomas identified from a large institutional pathologic database. A retrospective slide review of 500 thymic epithelial tumors identified 71 ( approximately 14%) cases of types A and AB thymomas. Clinical history and follow-up information were obtained through retrospective chart review. There were 38 and 33 cases of types A and AB thymomas, respectively. Complete follow-up data were available in 37 (52%) cases. Eighteen (49%) patients (type A, n=9 and type AB, n=9) had evidence of recurrent/metastatic disease at an average of 62 months (range from 6 to 244 months) after initial diagnosis. Survival curves for patients with types A and AB thymomas, with and without recurrences, show a statistically significant difference (P=0.001 and 0.005, respectively). Analysis of this large cohort confirms the potential for subtypes A and AB thymomas to show malignant behavior. Long-term clinical monitoring, therefore, appears to be justified in these cases. This study also shows the poor correlation between the WHO classification and tumor behavior.|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Female[MESH]|Humans[MESH]|Kaplan-Meier Estimate[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Staging[MESH]|Prognosis[MESH]|Retrospective Studies[MESH]|Thymoma/classification/mortality/*pathology[MESH]|Thymus Neoplasms/classification/mortality/*pathology[MESH]|World Health Organization[MESH] |
