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Vol.49 No.4 contents Japanese/English

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Article in Japanese

- Case Report -

A Surgical Case of Thymoma with Squamous Differentiation Associated with Primary Lung Cancer

Fumihiro Ishibashi1, Tomohisa Yasukawa1, Tomoko So1, Toshikazu Yusa1, Kenzo Hiroshima2
1Department of General Thoracic Surgery, Chiba Rosai Hospital, Japan, 2Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Japan

Background. We report a case of thymoma with squamous differentiation associated with lung cancer. Case. An 81-year-old man consulted his family doctor with chief complaints of shortness of breath and chest pain. A nodular shadow was noted in the left middle lung field of his chest X-ray, and the patient was referred to our Department of Respiratory Medicine. Transbronchial aspiration cytology was performed in the left B8a, and the tumor was diagnosed as adenocarcinoma. He was then referred to our department for surgery. The preoperative diagnosis of the lung cancer was classified as cT1N0M0 and stage IA by preoperative evaluation. Another 5.0×3.5 cm tumor was detected in the anterior mediastinum in the preoperative chest CT, and a thymoma was suspected. Simultaneous left lower lobectomy with lymphadenectomy (ND2a) and surgical removal of the anterior mediastinal tumor were performed. The postoperative histological examination revealed the lung cancer to be adenocarcinoma, pT2N0M0 and stage IB. The anterior mediastinal tumor was type B1 thymoma, showing squamous differentiation with keratinization. Conclusion. Thymoma with squamous differentiation is a rare histopathological feature. This case was valuable in that it suggested a relationship between thymoma and thymic carcinoma.
key words: Lung cancer, Thymoma, Squamous epithelium, Differentiation

Received: February 6, 2009
Accepted: March 11, 2009

JJLC 49 (4): 441-444, 2009

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