Thymoma calcification: Is it clinically meaningful?

Among anterior mediastinal lesions, thymoma is the most common. Thymomas are tumors of thymic epithelial cell origin that are distinguished by inconsistent histological and biologic behavior. Chest imaging studies typically show a round or lobulated tumor in the anterior mediastinum. Calcifications in thymomas are classically punctuate or amorphous, positioned within the lesion. Chest computed tomography (CT) features suggesting higher risk thymoma consist of tumor heterogeneity, vascular involvement, lobulation, pulmonary nodules, lymphadenopathy, and pleural manifestations. Imaging findings have an imperfect ability to predict stage and prognosis for thymoma patients. Our objective is to highlight the clinical implications of thymoma calcifications on the diagnosis, clinical manifestation and prognosis. A pubmed and google search was performed using the following words: thymoma calcification, calcified thymus, mediastinal calcification, anterior mediastinal calcification, and calcified thymoma. After reviewing 370 articles, 32 eligible articles describing thymoma calcifications were found and included in this review. Although the presence of thymus calcifications was more common in patients with invasive thymomas, they were present in significant portion of non-invasive thymomas. The presence of calcifications was not a significant factor in differentiating between benign and malignant thymoma. As a result, the type, location, size or other characteristics of thymus gland calcifications were not relevant features in clinical and radiologic diagnosis of thymoma. The histopathological diagnosis is still the only possible way to confirm the neoplastic nature of thymoma. All types of thymomas should be evaluated and managed independently of the presence of calcifications

Neuroendocrine Neoplasms of the Breast

Neuroendocrine differentiation in breast neoplasms has been a matter of discussion since the first description of a neuroendocrine neoplasm (NEN) in this site. In fact, NENs of the breast (Br-NENs) represent a less well-defined group of neoplasms than analogous entities in other organs, such as the lung and the gastroenteropancreatic tract. Pure neuroendocrine phenotype is extremely rare, both for the well- and for the poorly differentiated morphology. In contrast, the expression of neuroendocrine markers in otherwise typical breast carcinomas, both of special and of non-special type, without morphologically evident neuroendocrine differentiation is more common. Consequently, the diagnostic criteria and the classification scheme for Br-NENs have been continuously changing over time, and real consensus on this topic is still lacking. In this chapter, we recapitulate the evolution of the concept of Br-NEN; review the available knowledge on their morphological, molecular, and clinical features; and critically discuss the current classification scheme