胸腺腫 Thymoma
WHO分類 (WHO histologic typing of tumors of the thymus - Ⅰ）
| 1. Epithelial Tumors | |
| 1.1 Thymoma | |
| 1.1.1 Type A | spindle cell; medullary |
| 1.1.2 Type AB | mixed |
| 1.1.3 Type B1 | lymphocyte-rich; lymphocytic; predominantly cortical; organoid |
| 1.1.4 Type B2 | cortical |
| 1.1.5 Type B3 | epithelial; atypical; squamoid; well-differenciated thymic carcinoma |
| 1.2 Thymic carcinoma(type C thymoma) | |
| 1.2.1 Epidermoid keratinizing(squamous cell) carcinoma | |
| 1.2.2 Epidermoid non-keratinizing carcinoma | |
| 1.2.3 Lymphoepithlioma-like carcinoma | |
| 1.2.4 Sarcomatoid carcinoma(carcinosarcoma) | |
| 1.2.5 Clear cell carcinoma | |
| 1.2.6 Basaloid carcinoma | |
| 1.2.7 Mucoepidermoid carcinoma | |
| 1.2.8 Papillary carcinoma | |
| 1.2.9 Undifferentiated carcinoma | |
| 2. Neuroendocrine tumors | |
| 2.1 Carcinoid tumor(well-differentiated neuroendocrine carcinoma) | |
| 2.1.1 classic | |
| 2.1.2 Spindle cell | |
| 2.1.3 Pigmented | |
| 2.1.4 With amyloid(extrathyroid medullary carcinoma) | |
| 2.2 Small cell carcinoma(Poorly differentiated neuroendocrine carcinoma) | |
| 2.2.1 Mixed small cell-epidermoid keratinizing carcinoma | |
| 2.3 Large cell neuroendocrine carcinoma | |
| 3. Germ cell tumors | |
| 3.1 Seminoma(germinoma) | |
| 3.2 Embryonal carcinoma | |
| 3.3 Yolk sac tumor | |
| 3.4 Choriocarcinoma | |
| 3.5 Teratoma | |
| 3.5.1 Mature teratoma | |
| 3.5.2 Immature teratoma | |
| 3.5.3 With sarcoma | |
| 3.6 Mixed germ cell tumor | |
ステージ分類（Masaoka 分類）
| Stage | discription | 5ys | 20ys |
| Stage Ⅰ | Macroscopically completely encapsulated and microscopically no capsular invasion | 96% | 89% |
| Stage Ⅱ | Macroscopically invasion into surrounding fatty tissue or mediastinal pleura, or microscopic invasion into capsule | 86% | 91% |
| Stage Ⅲ | Macroscopic invasion into neighboring organs, ie, pericardium, great vessels, or lung | 69% | 49% |
| Stage Ⅳa | Pleural or pericardial dissemination | 50% | 0% |
| Stage Ⅳb | Lymphogenous or hematogenous metastasis |
5ys; Masaoka A, et al. Cancer 48(11) : 2485-92, 1981
20ys; Okuymura M, et al. Cancer 94(3):624-32, 2002
治療
非浸潤性胸腺腫：手術
浸潤性胸腺腫
手術可能な場合：手術後放射線療法の追加
手術不可能な場合（胸膜浸潤、心膜は腫、大静脈浸潤）：放射線療法による局所制御
化学療法について：まだ確立されていない
PAC（CDDP+Doxorubicin+CPM)
ADOC（Doxorubicin+CDDP+VCR+CPM)
PE
Ifo単独
などが試みられる