Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0268596 (EMA)
 2,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight cases of thymic carcinoma (mean age 62 years, 5 males and 3 females) were treated in our hospital from Apr. 1988 to Mar. 1993, which were 21% of thymic epithelial tumors. The histologic subtypes of thymic carcinoma were 3 squamous, 4 undifferentiated, and 1 adenocarcinoma, respectively. Computed tomography showed extrathymic metastases to the mediastinal lymph nodes in 6 cases. All cases underwent thoracotomy, and postoperative radiotherapy or chemotherapy were performed. A case of squamous cell carcinoma in stage II who underwent total resection followed by irradiation is alive and disease free 5 years after surgery. However, the remaining 7 cases died of the disease within 29 months. 8 cases of thymic carcinoma and 7 of thymoma were studied immunohistologically on the formalin-fixed and paraffin-embedded tissues. Higher positivity of EMA in thymic carcinoma was noted comparing to ordinary thymoma, suggesting that EMA is a useful parameter of potential malignancy of the thymic epithelial neoplasms.
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PMID:[Eight cases of thymic carcinoma]. 783 17

Thymoma with psuedosarcomatous stroma is a recently described, rare variant of thymomas that are characterized by having a biphasic histologic pattern which consists of both an epithelial and a spindle cell stromal component. So far only 11 cases having similar histologic findings have been reported worldwide. At this time we report a case of this rare variant of thymoma which occurred in a 53-year-old Korean man. This previously healthy patient presented with coughing and an anterior mediastinal mass was then detected radiographically. Mediastinal exploration revealed a 9 x 8 x 8 cm-sized well- encapsulated, ovoid, cystic mass. Histological examination showed a biphasic neoplasm composed of anastomosing nests of epithelial cells and somewhat cellular stromal spindle cells that had advanced degenerative changes. Immunohistochemical staining using the antibodies for cytokeratins, EMA, e-cadherin, and p75NGFR showed a strong expression of these markers in the epithelial component but no expression in the spindle stromal cells. The epithelial tumor cells showed no reactivity to CD5 and L26 and a high proportion of the infiltrated lymphocytes were the cortical type that expressed CD99 and terminal deoxynucleotidyl transferase. Ultrastructural examinations revealed tonofilaments in the spindle cells. Follow up has been done for 5 years after the surgical excision and the patient has been free of disease during that period. Similar to previous reports, this patient had a benign clinical course that was unassociated with myasthenia gravis which appears to be a characteristic of this histologic variant of thymoma. However, our case also showed advanced degenerative features and we could demonstrate ultrastructural evidence of epithelial differentiation in the stromal spindle cells that were not mentioned in the previously reported cases. Based on the results of our studies, we suggest this entity is a distinct type of organotypic thymoma that shows cortical differentiation and abundant cellular stroma.
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PMID:Thymoma with pseudosarcomatous stroma. 1167 89

Thymomas with the characteristic pattern of small epithelial nodules separated by an abundant lymphoid tissue have been recently described with divergent interpretations. These thymomas are not specified in currently used classification systems. We present six such thymomas, including three that represented 1.38% of a series of 217 consecutive cases. These thymomas were totally encapsulated (Masaoka stage I, n=1) or minimally invasive (stage II, n=5). The epithelial cells of the nodules were oval and bland-appearing. In one case, these cells formed rosettes. Cysts, that were present in four cases, showed a strong linear expression of EMA and were associated with foci of glandular differentiation. The lymphoid tissue was composed of large immature (CD1a and CD99-positive) T-cell areas (with epithelial cells restricted to small foci of residual thymus) and of B-cell (CD20-positive) areas with germinal centers. Mature T-cells were also present. Furthermore, one case, associated with myasthenia gravis, had an important WHO type B2 (cortical) component. Such a combined case has not been previously reported. Our study demonstrates that so-called micronodular thymomas are rare, usually have clinical and pathological features of WHO type A (medullary) thymomas, and that the lymphoid component is hyperplastic corresponding to both immature T-cell lymphoid tissue and B-cell lymphoid hyperplasia with germinal centers.
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PMID:[Thymoma with epithelial micronodules and lymphoid hyperplasia: six cases of a rare and equivocal subtype]. 1241 Jan

In this report, a case of metaplastic thymoma arising in a thymic cyst wall is discussed. The patient was a 61-year-old male whose chief complaint was sweating and chest pain. Imaging study revealed a mediastinal mass with right hemithoracic extension. He underwent surgical resection of the mass and remnants of the thymus. Histologic studies showed a primary thymic neoplasm with a biphasic histologic pattern composed of 2 distinct epithelial and stromal components arising in a thymic cyst wall. Immunohistochemically, the epithelial component was cytokeratin positive and focally reactive for EMA. Marked expression of EMA and vimentin was seen in spindle cells. Metaplastic thymoma is an extremely rare variant of primary thymic epithelial neoplasms with only a few cases reported in the literature.
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PMID:Metaplastic thymoma: report of an unusual thymic epithelial neoplasm arising in the wall of a thymic cyst. 1839

Primary mediastinal large B-cell lymphoma (PMLBL) is an uncommon non-Hodgkin lymphoma with a distinct clinicopathological entity in the WHO classification of lymphoid malignancies. It is known to originate from B-cells of the thymus. It mimics thymic neoplasms and other lymphomas clinically and histopathologically. We reported a 33-year-old obese man who presented with shortness of breath off and on for 4 years. Radiologically, there was a huge anterior mediastinal mass. Tru-cut biopsy was initially diagnosed as type-A thymoma. Histopathological examination of the excised specimen revealed PMLBL with stromal fibrosis and sclerosis which created a diagnostic difficulty. The neoplastic cells varied from medium-sized to large pleomorphic cells, including mononuclear cells with centroblastic and immunoblastic features as well as bi-lobed Reed Sternberg (RS)-like cells and horse-shoe like hallmark cells. Some interlacing spindle cells and epithelioid cells were also present. Immunohistochemically, tumour cells expressed diffuse positivity for LCA, CD20, CD79a, CD23, Bcl2, MUM-1 and heterogenous positivity for CD30 and EMA, and were negative for CD10, CD15 and ALK. Ki67 scoring was very high. Tumour cells infiltrated into peri-thymic fat and pericardium. No malignant cells were detected in the pleural fluid and there was no bone marrow infiltration. The patient showed partial response to 6 cycles of RICE chemotherapy, and was planned for second line chemotherapy using hyper-CVAD regimen followed by autologous stem cell transplantation. This case illustrates the importance of thorough sampling and immunohistochemistry in differentiating PMLBL from its differential diagnoses.
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PMID:Primary mediastinal large B-cell lymphoma and its mimickers: a rare case report with literature review. 2756 73