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Case Reports
. 2023 Apr 20;18(6):2307-2310.
doi: 10.1016/j.radcr.2023.03.029. eCollection 2023 Jun.

Massive true thymic hyperplasia with osseous metaplasia

Jun Kanzawa  1 , Mitsuru Matsuki  2 , Shintaro Kano  1 , Akihiro Nakamata  1 , Waka Nakata  2 , Rieko Furukawa  2 , Katsuhisa Baba  3 , Shigeru Ono  3 , Harushi Mori  1
Affiliations
Case Reports

Massive true thymic hyperplasia with osseous metaplasia

Jun Kanzawa et al. Radiol Case Rep. .

Abstract

True thymic hyperplasia is defined as an increase in both the size and weight of the gland, while maintaining a normal microscopic architecture. Massive true thymic hyperplasia is a rare type of hyperplasia that compresses adjacent structures and causes various symptoms. Limited reports address the imaging findings of massive true thymic hyperplasia. Herein, we report a case of massive true thymic hyperplasia in a 3-year-old girl with no remarkable medical history. Contrast-enhanced CT revealed an anterior mediastinal mass with a bilobed configuration containing punctate and linear calcifications in curvilinear septa, which corresponded to lamellar bone deposits in the interlobular septa. To our knowledge, this is the first report of massive true thymic hyperplasia with osseous metaplasia. We also discuss the imaging features and etiology of massive true thymic hyperplasia with osseous metaplasia.

Keywords: Massive true thymic hyperplasia; Osseous metaplasia.

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Figures

Fig 1
Fig. 1
Chest radiograph. Chest radiography on admission reveals a large mass extending from the left to the right hemithorax.
Fig 2
Fig. 2
Unenhanced CT images (A), (B). Unenhanced CT images show a large anterior mediastinal mass with linear and punctate calcifications (arrows).
Fig 3
Fig. 3
Contrast-enhanced CT images (A), (B). Contrast-enhanced CT images show a bilobed mass in the anterior mediastinum and linear and punctate calcifications arranged in curvilinear septa (arrows). Consequently, thymic hyperplasia was suspected.
Fig 4
Fig. 4
Surgical specimen. Surgical specimen demonstrates an enlarged thymus retaining its original structure.
Fig 5
Fig. 5
Histopathology specimen with hematoxylin and eosin staining. Histopathological examination of the specimen reveals hyperplastic thymic tissue with preserved lobular pattern. Lamellar bone deposits were found in the thickened interlobular septa (arrows).
Fig 6
Fig. 6
Thymic Langerhans cell histiocytosis: 2-month-old girl. Unenhanced CT image shows an anterior mediastinal mass with randomly distributed punctate calcifications (arrows).
Fig 7
Fig. 7
Mature teratoma in the anterior mediastinum: 11-year-old girl. Unenhanced CT image shows an anterior mediastinal mass with discrete fatty components (arrowheads) and dense calcifications (arrows).
See this image and copyright information in PMC

References

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