診断に苦慮した壊死性胸腺腫の1例

Necrotic Thymoma；Report of a Case

はじめに　胸腺の腫瘍には，胸腺上皮性腫瘍，リンパ腫，胚細胞腫瘍，間質性腫瘍などがあるが，その臨床的診断にはしばしば難渋することがある．急激な胸痛により発症し，広汎な壊死のため病理診断がつかず治療方針の決定に苦慮した胸腺腫の1例について報告する．

A 36-year-old man, who had never been detected abnormalities on an annual chest X-ray check up, presented with a sudden onset of right-sided chest pain and fever. Contrast-enhanced computed tomography showed an anterior mediastinal mass with necrosis or hemorrhage and right pleural effusion. Neither computed tomography-guided biopsy nor video-assisted thoracic surgery （VATS） yielded definitive histological diagnosis due to insufficiency of the sample. For diagnosis and treatment, we performed thymectomy. Histopathologically, the tumor was almost entirely necrotic with few viable tumor cells on periphery. A diagnosis of B2 thymoma was rendered.