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Ektopien des Thymus und ektope Thymustumoren

Ectopic thymic tissue and ectopic thymic tumors

  • Schwerpunkt: Ektopes Gewebe
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Zusammenfassung

Ektopien von Thymusgewebe außerhalb des „Thymus-Kerngebiets“ im vorderen, oberen Mediastinum sind aufgrund der komplexen Embryonalentwicklung des Thymus relativ häufig, wobei berichtete Prävalenzen (1–90 %) stark von der Untersuchungsmethode und Intensität der Aufarbeitung abhängen. Die Frage der Prävalenz und Relevanz ektopen Thymusgewebes und seiner Erreichbarkeit über verschiedene chirurgische Zugänge liegt der aktuellen Diskussion darüber zugrunde, ob als Therapie der Mysthenia gravis die Thymektomie mittels moderner minimalinvasiver Strategien den erwiesenermaßen wirksamen, radikalen, transsternalen Thymektomieverfahren ebenbürtig ist. Der folgende Artikel behandelt vor diesem Hintergrund die Ätiologie, Häufigkeit und Lokalisation der Ektopien des histologisch normalen, reaktiv und neoplastisch veränderten Thymus. Außerdem finden Ektopien anderer Gewebe und Tumoren im Thymus Erwähnung.

Abstract

Ectopic thymic tissue outside its core position in the antero-superior mediastinum is quite common owing to the complexity of embryonal thymus development, whereby reported prevalence values (1 to 90%) are heavily dependent on the method of investigation and the intensity of the workup. The debated prevalence and relevance of ectopic thymic tissue and its accessibility underlie the ongoing discussion whether modern, minimally invasive thymectomy strategies can match the proven benefit of the radical transsternal thymectomy procedure for the treatment of Myasthenia gravis. In this context, the following article covers the etiology, prevalence, and location of normal-looking, reactive, and neoplastic ectopic thymic tissue. Furthermore, ectopic tissues and tumors inside or adjacent to the thymus are mentioned.

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Authors and Affiliations

  1. Pathologisches Institut, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim, Deutschland

    A. Marx &  C.‑A. Weis

  2. Pathologisches Institut, Klinikum Karlsruhe, Karlsruhe, Deutschland

    T. Rüdiger

  3. Chirurgische Klinik, Universitätsmedizin Mannheim, Mannheim, Deutschland

    E. Rößner

  4. Institut für Pathologie, Universitätsspital Basel, Basel, Schweiz

    A. Tzankov

  5. Service d’Anatomie & de Cytologie Pathologiques, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Frankreich

    V. T. de Montpréville

  6. Pathologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland

    R. R. Rieker

  7. Institut für Pathologie, Universitätsmedizin Göttingen, Göttingen, Deutschland

    P. Ströbel

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A. Marx, T. Rüdiger, E. Rößner, A. Tzankov, V. T. de Montpréville, R. R. Rieker, P. Ströbel und C.-A. Weis geben an, dass kein Interessenkonflikt besteht.

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Marx, A., Rüdiger, T., Rößner, E. et al. Ektopien des Thymus und ektope Thymustumoren. Pathologe 39, 390–397 (2018). https://doi.org/10.1007/s00292-018-0485-z

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