Other Classifications
A number of classifications have been used and proposed over the years
- None of them approach the prognostic significance of staging
- Some of these classifications:
- Bernatz proposed the classical, descriptive system used for many years
- Muller-Hermelink proposed a functional system based on perceived similarities with normal subsets of thymic epithelial cells (Kirchner)
- WHO consensus essentially applied new names to the Muller-Hermelink system
- Moran and Suster have proposed simplifications under a variety of names, basically grouping types A, AB, B1 and B2 because their behavior is determined by stage rather than histologic pattern
Bernatz | Muller-Hermelink | WHO | Moran & Suster | Simplest Version of Suster & Moran |
---|---|---|---|---|
Spindle cell | Medullary | A | Well differentiated TEN / Low grade thymoma | Thymoma |
Some mixed | Mixed | AB | Well differentiated TEN / Low grade thymoma | Thymoma |
Lymphocyte rich | Predominantly cortical | B1 | Well differentiated TEN / Low grade thymoma | Thymoma |
Some mixed | Cortical | B2 | Well differentiated TEN / Low grade thymoma | Thymoma |
Epithelial rich | Well differentiated thymic carcinoma | B3 | Moderately differentiated TEN / Intermediate grade thymoma | Atypical thymoma |
Bibliography
- Shimosato Y, Mukai K, Matsuno Y. Tumors of the Mediastinum, Atlas of Tumor Pathology, AFIP Fourth Series, Fascicle 11, 2010
- Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC eds. World Health Organization Classification of Tumors. Pathology and genetics of tumors of the lung, pleura, thymus and heart. IARC Press: Lyon 2004.
- Bernatz PE, Harrison EG, Clagett OT. Thymoma: a clinicopathologic study. J Thorac Cardiovasc Surg. 1961 Oct;42:424-44.
- Kirchner T, Schalke B, Buchwald J, Ritter M, Marx A, Müller-Hermelink HK. Well-differentiated thymic carcinoma. An organotypical low-grade carcinoma with relationship to cortical thymoma. Am J Surg Pathol. 1992 Dec;16(12):1153-69.
- Suster S, Moran CA. Histologic classification of thymoma: the World Health Organization and beyond. Hematol Oncol Clin North Am. 2008 Jun;22(3):381-92.
- Marchevsky AM, Gupta R, McKenna RJ, Wick M, Moran C, Zakowski MF, Suster S. Evidence-based pathology and the pathologic evaluation of thymomas: the World Health Organization classification can be simplified into only 3 categories other than thymic carcinoma. Cancer. 2008 Jun 15;112(12):2780-8.