Title:Imaging and Histopathological Features Of Primary Thymic Neuroendocrine
Tumor
Volume: 20
Author(s): Sushant Suwal, Ying-ying Chen, Sui-dan Huang, Wei-feng Li and Huai Chen*
Affiliation:
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Keywords:
Primary thymic neuroendocrine tumors, Computed tomography, Magnetic resonance imaging, Positron emission tomography, NETTs, Neoplasms.
Abstract:
Objectives:
To investigate CT, MRI, and PET/CT features with histopathological findings of primary thymic neuroendocrine tumor.
Materials and Methods:
All 9 cases with pathologically proven primary thymic neuroendocrine tumors were reviewed retrospectively. Among them, 7 underwent enhanced
CT, 1 with MRI (enhanced) and another with PET/CT scan. Multiple characters were examined, including tumor location, contour, CT attenuation,
enhancement pattern, involvement of surrounding structure and lymphadenopathy.
Results:
Among 9 patients studied, 7 (77%) masses were located in the anterior superior mediastinum, 1 in the anterior superior-middle mediastinum, and 1
in the anterior and middle mediastinum. The maximum diameter (longitudinal) ranged from 4.2 to 23 cm (mean ± standard deviation, 9.5 cm ±
2.8). Four masses had irregular, 3 had lobulated, and 2 had smooth contours, while 8 masses had clear margins and 1 had an ill-defined margin. Six
masses showed heterogeneous attenuation with necrotic/cystic component (n=5), calcification (n=2) and hemorrhage(n=1), and 3 showed
homogeneous attenuation on the non-enhanced image. After contrast administration, 8 masses showed heterogeneous attenuation, and 1 showed
homogeneous attenuation with tumor vessels visible in 4 masses. Among all, 8 masses showed strong enhancement, and 1 showed moderate
enhancement in comparison to muscles in the anterior thoracic wall on enhanced images. Involvement of adjacent mediastinal structures was
observed in 5 cases. Immunohistochemical analysis showed that the tumor cells were positive for CgA, Syn, CK, CD56 and EMA.
Conclusion:
Primary NETs are large masses located anterior superior mediastinum, irregular in contour, showing heterogeneous attenuation with necrotic/cystic
component and strong heterogeneous enhancement with tumor vessels, compressing local mediastinal structures. In addition, immunohistochemical
examination is required in such a diagnosis.
