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Thymic Cyst
Aletta Ann Frazier, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Congenital thymic cyst: Embryonic remnants of thymopharyngeal duct
              • Acquired thymic cyst
                • Inflammatory: Infection, autoimmune disorders
                  • Myasthenia gravis, Sjögren syndrome, Langerhans cell histiocytosis
                • Association with malignant neoplasia
                • Other associations: Surgery, radiation, chemotherapy
                • Multilocular thymic cyst: 1% of children with HIV

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Garrana SH et al: Imaging of the anterior/prevascular mediastinum. Radiol Clin North Am. 59(2):155-68, 2021
                                        2. Heeger AP et al: Added value of magnetic resonance imaging for the evaluation of mediastinal lesions. Radiol Clin North Am. 59(2):251-77, 2021
                                        3. Hammer MM et al: Errors in interpretation of magnetic resonance imaging for thymic lesions. J Thorac Imaging. 34(6):351-5, 2019
                                        4. Kim H et al: Growth of thymic epithelial tumors and thymic cysts: differential radiological points. Thorac Cancer. 10(4):864-71, 2019
                                        5. Lee SH et al: Distinguishing between thymic epithelial tumors and benign cysts via computed tomography. Korean J Radiol. 20(4):671-82, 2019
                                        6. Shen X et al: Thymoma and thymic carcinoma associated with multilocular thymic cyst: a clinicopathologic analysis of 18 cases. Diagn Pathol. 13(1):41, 2018
                                        7. Carter BW et al: ITMIG classification of mediastinal compartments and multidisciplinary approach to mediastinal masses. Radiographics. 37(2):413-36, 2017
                                        8. Wang X et al: Clinical features, diagnosis and thoracoscopic surgical treatment of thymic cysts. J Thorac Dis. 9(12):5203-11, 2017
                                        9. Ackman JB et al: High rate of unnecessary thymectomy and its cause. Can computed tomography distinguish thymoma, lymphoma, thymic hyperplasia, and thymic cysts? Eur J Radiol. 84(3):524-33, 2015
                                        10. Araki T et al: Intrathymic cyst: clinical and radiological features in surgically resected cases. Clin Radiol. 69(7):732-8, 2014
                                        11. Nakamura S et al: Multilocular thymic cyst associated with thymoma: a clinicopathologic study of 20 cases with an emphasis on the pathogenesis of cyst formation. Am J Surg Pathol. 36(12):1857-64, 2012
                                        12. Nasseri F et al: Clinical and radiologic review of the normal and abnormal thymus: pearls and pitfalls. Radiographics. 30(2):413-28, 2010
                                        13. Takahashi K et al: Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 32(6):1325-39, 2010
                                        14. Suster S et al: Mediastinum. In Modern Surgical Pathology. 2nd ed. Saunders/Elsevier. 2009
                                        15. Maher MM et al: Imaging of thymoma. Semin Thorac Cardiovasc Surg. 17(1):12-9, 2005
                                        16. Restrepo CS et al: Imaging findings of expansile lesions of the thymus. Curr Probl Diagn Radiol. 34(1):22-34, 2005
                                        17. Jeung MY et al: Imaging of cystic masses of the mediastinum. Radiographics. 22 Spec No:S79-93, 2002
                                        18. Choi YW et al: Idiopathic multilocular thymic cyst: CT features with clinical and histopathologic correlation. AJR Am J Roentgenol. 177(4):881-5, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Congenital thymic cyst: Embryonic remnants of thymopharyngeal duct
                                                    • Acquired thymic cyst
                                                      • Inflammatory: Infection, autoimmune disorders
                                                        • Myasthenia gravis, Sjögren syndrome, Langerhans cell histiocytosis
                                                      • Association with malignant neoplasia
                                                      • Other associations: Surgery, radiation, chemotherapy
                                                      • Multilocular thymic cyst: 1% of children with HIV

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Garrana SH et al: Imaging of the anterior/prevascular mediastinum. Radiol Clin North Am. 59(2):155-68, 2021
                                                                              2. Heeger AP et al: Added value of magnetic resonance imaging for the evaluation of mediastinal lesions. Radiol Clin North Am. 59(2):251-77, 2021
                                                                              3. Hammer MM et al: Errors in interpretation of magnetic resonance imaging for thymic lesions. J Thorac Imaging. 34(6):351-5, 2019
                                                                              4. Kim H et al: Growth of thymic epithelial tumors and thymic cysts: differential radiological points. Thorac Cancer. 10(4):864-71, 2019
                                                                              5. Lee SH et al: Distinguishing between thymic epithelial tumors and benign cysts via computed tomography. Korean J Radiol. 20(4):671-82, 2019
                                                                              6. Shen X et al: Thymoma and thymic carcinoma associated with multilocular thymic cyst: a clinicopathologic analysis of 18 cases. Diagn Pathol. 13(1):41, 2018
                                                                              7. Carter BW et al: ITMIG classification of mediastinal compartments and multidisciplinary approach to mediastinal masses. Radiographics. 37(2):413-36, 2017
                                                                              8. Wang X et al: Clinical features, diagnosis and thoracoscopic surgical treatment of thymic cysts. J Thorac Dis. 9(12):5203-11, 2017
                                                                              9. Ackman JB et al: High rate of unnecessary thymectomy and its cause. Can computed tomography distinguish thymoma, lymphoma, thymic hyperplasia, and thymic cysts? Eur J Radiol. 84(3):524-33, 2015
                                                                              10. Araki T et al: Intrathymic cyst: clinical and radiological features in surgically resected cases. Clin Radiol. 69(7):732-8, 2014
                                                                              11. Nakamura S et al: Multilocular thymic cyst associated with thymoma: a clinicopathologic study of 20 cases with an emphasis on the pathogenesis of cyst formation. Am J Surg Pathol. 36(12):1857-64, 2012
                                                                              12. Nasseri F et al: Clinical and radiologic review of the normal and abnormal thymus: pearls and pitfalls. Radiographics. 30(2):413-28, 2010
                                                                              13. Takahashi K et al: Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 32(6):1325-39, 2010
                                                                              14. Suster S et al: Mediastinum. In Modern Surgical Pathology. 2nd ed. Saunders/Elsevier. 2009
                                                                              15. Maher MM et al: Imaging of thymoma. Semin Thorac Cardiovasc Surg. 17(1):12-9, 2005
                                                                              16. Restrepo CS et al: Imaging findings of expansile lesions of the thymus. Curr Probl Diagn Radiol. 34(1):22-34, 2005
                                                                              17. Jeung MY et al: Imaging of cystic masses of the mediastinum. Radiographics. 22 Spec No:S79-93, 2002
                                                                              18. Choi YW et al: Idiopathic multilocular thymic cyst: CT features with clinical and histopathologic correlation. AJR Am J Roentgenol. 177(4):881-5, 2001