A report on five cases of cholesterol granulomas in the thymus.

Ryosuke Matsuda, Naoko Ose, Hideki Nagata, Eiichi Morii, Yasushi Shintani
{"title":"A report on five cases of cholesterol granulomas in the thymus.","authors":"Ryosuke Matsuda, Naoko Ose, Hideki Nagata, Eiichi Morii, Yasushi Shintani","doi":"10.1186/s44215-024-00159-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cholesterol granuloma (CG) is a benign entity characterized by the presence of cholesterol crystals and foreign body giant cells. This condition can be attributed to cholesterol crystals that are deposited in the tissues and react with foreign body giant cells, resulting in granuloma formation. Lesions commonly develop in the otolaryngeal region, such as the middle ear. However, crystals rarely form in the thymus, accounting for 1% of all mediastinal tumors. Herein, we present five cases of mediastinal CG.</p><p><strong>Case presentation: </strong>The patients were aged 49-61 (mean, 55.4) years. Among them, three were men and two women. One patient had fever, and four patients were asymptomatic. The patients' lesions were detected during follow-up of other diseases or medical examinations showing the presence of abnormal chest shadows. The patients did not have a history of trauma or surgery. All lesions were located within the thymus gland. Three patients presented with multifocal lesions and two with a single lesion. Four patients had contrast effect on computed tomography scan. Four patients had abnormal fluorodeoxyglucose accumulation (mean maximum standardized uptake value, 4.67) on positron emission tomography-computed tomography. Four patients underwent complete surgical resection. The size of the resected lesions ranged from 1.8 to 5.1 (mean, 3.24) cm. Histologically, all patients presented with small nodules with cholesterol clefts and foreign body giant cells and histiocyte infiltration within the thymic tissue. The postoperative course was excellent. None of the patients who underwent complete resection presented with recurrence. Moreover, the patient who underwent partial resection did not have lesion enlargement.</p><p><strong>Conclusions: </strong>CG in the thymus is clinically challenging to differentiate from malignant lesions, and histologic diagnosis via surgical resection is required.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"3 1","pages":"36"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533621/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"General Thoracic and Cardiovascular Surgery Cases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s44215-024-00159-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Cholesterol granuloma (CG) is a benign entity characterized by the presence of cholesterol crystals and foreign body giant cells. This condition can be attributed to cholesterol crystals that are deposited in the tissues and react with foreign body giant cells, resulting in granuloma formation. Lesions commonly develop in the otolaryngeal region, such as the middle ear. However, crystals rarely form in the thymus, accounting for 1% of all mediastinal tumors. Herein, we present five cases of mediastinal CG.

Case presentation: The patients were aged 49-61 (mean, 55.4) years. Among them, three were men and two women. One patient had fever, and four patients were asymptomatic. The patients' lesions were detected during follow-up of other diseases or medical examinations showing the presence of abnormal chest shadows. The patients did not have a history of trauma or surgery. All lesions were located within the thymus gland. Three patients presented with multifocal lesions and two with a single lesion. Four patients had contrast effect on computed tomography scan. Four patients had abnormal fluorodeoxyglucose accumulation (mean maximum standardized uptake value, 4.67) on positron emission tomography-computed tomography. Four patients underwent complete surgical resection. The size of the resected lesions ranged from 1.8 to 5.1 (mean, 3.24) cm. Histologically, all patients presented with small nodules with cholesterol clefts and foreign body giant cells and histiocyte infiltration within the thymic tissue. The postoperative course was excellent. None of the patients who underwent complete resection presented with recurrence. Moreover, the patient who underwent partial resection did not have lesion enlargement.

Conclusions: CG in the thymus is clinically challenging to differentiate from malignant lesions, and histologic diagnosis via surgical resection is required.

关于五例胸腺胆固醇肉芽肿的报告。
背景:胆固醇肉芽肿(CG)是一种良性肿瘤,其特征是存在胆固醇结晶和异物巨细胞。这种疾病可归因于沉积在组织中的胆固醇结晶与异物巨细胞发生反应,从而形成肉芽肿。病变通常发生在耳咽部位,如中耳。然而,胸腺中很少形成结晶,仅占纵隔肿瘤总数的 1%。在此,我们介绍五例纵隔CG病例:患者年龄在 49-61 岁(平均 55.4 岁)之间。病例介绍:患者年龄在 49-61 岁(平均 55.4 岁)之间,其中男性 3 例,女性 2 例。一名患者发烧,四名患者无症状。患者的病变是在随访其他疾病或体检时发现的,体检结果显示患者胸部有异常阴影。患者均无外伤或手术史。所有病灶均位于胸腺内。三名患者为多灶病变,两名患者为单灶病变。四名患者的计算机断层扫描出现造影剂效应。四名患者的正电子发射断层扫描-计算机断层扫描显示氟脱氧葡萄糖异常积聚(平均最大标准化摄取值为4.67)。四名患者接受了完整的手术切除。切除病灶的大小从 1.8 厘米到 5.1 厘米(平均 3.24 厘米)不等。从组织学角度来看,所有患者的胸腺组织内都出现了带有胆固醇裂隙、异物巨细胞和组织细胞浸润的小结节。术后情况良好。完全切除的患者无一复发。此外,接受部分切除术的患者也没有出现病灶扩大的情况:结论:胸腺中的 CG 在临床上很难与恶性病变相鉴别,需要通过手术切除进行组织学诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信