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Published Online First: 5 May 2006. doi:10.1136/jcp.2005.031138
Journal of Clinical Pathology 2006;59:1238-1244
Copyright © 2006 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

MY APPROACH

Diagnosis of thymoma

S Suster

Correspondence to:
Correspondence to:
S Suster
Department of Pathology, Ohio State University, E-411 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA;saul.suster{at}odumc.edu

ABSTRACT

The diagnosis of thymic epithelial neoplasm has been a topic of controversy for many years. Reasons for this include the lack of predictive value associated with the morphology of these tumours and the multiplicity of classification schemes and terminologies proposed over the years. Recently, a new classification schema was introduced by the World Health Organization (WHO) in an attempt to standardise nomenclature and facilitate the diagnosis of primary thymic epithelial neoplasms. This schema, although not originally intended as a new histological classification, but rather as a means for translating equivalent terms from the various existing classifications, has represented a major step forward in this direction. However, problems still exist with the WHO schema, particularly with some of the criteria for the various histological subtypes as well as with issues of interobserver reproducibility. For this reason, we favour using a much more simplified approach to the morphological classification of thymic epithelial neoplasms. A personal approach to the morphological diagnosis of thymoma is described, with a brief explanation for the rationale for simplifying the existing diagnostic categories.

Abbreviations: CAP, College of American Pathologists; WHO, World Health Organization


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