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CT scan showed soft tissue attenuation lesion in thymus gland encasing brachiocephalic vein. Thymic hyperplasia. What is it?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
my brother son was diagnosed by CT Scan,

Imperssion was:
well defined homogeneously enhancing soft tissue attenuation leison in
the region of the thymus gland encasing the adjacent left
Brachiocethalic venin and isa partially encasing the adjacent aorotic
arch vessesl.

DD: Thymo Thymoma Thymic Hyperplasia,

please explain what is it, and is it curable by mediciene or is there any other remedies to tackle.
Posted Sun, 8 Jul 2012 in Child Health
Answered by Dr. Hema Yadav 3 hours later
Thanks for posting your query.
The thymus gland located in anterior central part of chest is a normal gland found in all humans during their childhood which is a part of the immune system of our body .
It regresses later as we grow older . Like any other organ of our body it can be affected by a tumor like growth of its cells ( either benign or malignant ) which is called thymoma . Such tumor mass or thymoma can occur in anyone .Infact,
Thymomas are rare in children and adolescents; however, thymomas in this age group are highly aggressive.
According to the child's CT scan report his thymus gland is showing some tumor like mass( thymoma or hyperplasia) which is encasing the major blood vessels nearby( brachiocephalic vein and aortic arch).
Although the treatment of choice for thymoma is surgical resection, chemotherapy and/or radiation has been shown to decrease the rate of tumor recurrence when complete excision is not possible. It's best to go for surgery even in early stages since it improves the prognosis.However ,Surgery can be challenging because of the tendency of the tumor to surround blood vessels, bronchi, and other mediastinal structures. Excessive bleeding can complicate thymectomy of large tumors that have become vascular .
As in this child's case it has already encased the mediastinal blood vessels I assume the treating doctor will discuss the treatment plan including surgery, radiotherapy and or chemotherapy depending on the staging of the thymoma in this child.
Though there can be many associated complications like a muscle weakness ( myasthenia ) , immunodeficiency , recurrence of tumor after surgery, the overall survival varies from 25- 100% depending on stage and individual case .
Hope I have answered your query.
I'll be available for any follow up queries.

Above answer was peer-reviewed by
Follow-up: CT scan showed soft tissue attenuation lesion in thymus gland encasing brachiocephalic vein. Thymic hyperplasia. What is it? 8 hours later
A well defined homogenously enhancing soft tissue attenuation leison noted in the region of the thymus gland measuring 4.2x3.2x4.2
The leison is encasing the adjacent left brachioephalic vein and is a partially encasing the adjacent arch vesse.

from the above report is it possible to find out the the severity of the tumour
Answered by Dr. Hema Yadav 5 hours later
Thanks for the follow up.
The severity of the tumor can be known by its histologic grading ie microscopic examination of the tumor tissue obtained by biopsy or aspiration.
The radiologic staging also gives an idea about the prognosis and is called the
Masaoka Staging System of Thymoma.
According to that this tumor might be progressed to stage 2 or 3 since its involving other organs in chest like the brachiocephalic vein and arch of aorta .
However the prognosis depends on many other factors like age of patient(<30 years is high risk ), symptoms of patient( presence of symptoms shows poor prognosis) size of Tumor( >10 cm is associated with poor prognosis ) and histologic classification of the cells of tumor(Epithelial or mixed histology shows poor prognosis).
So the best person to assess the severity would be the child's treating oncosurgeon .
All I can comment from the given report is that though the size is not very large the tumor is not a low risk one since its involving major blood vessels and hence needs to be treated as soon as feasible .
Hope that answers your query .
Kindly accept my answer if you have no further queries.
Wishing the child a speedy recovery and good health.
Above answer was peer-reviewed by
Follow-up: CT scan showed soft tissue attenuation lesion in thymus gland encasing brachiocephalic vein. Thymic hyperplasia. What is it? 1 hour later
what is the survival rate for eg. if it is treated sucessfully, he can live long as normal person.
Answered by Dr. Hema Yadav 21 minutes later
Thanks for the follow up.

Survival rates are often used by doctors as a standard way of discussing a person's prognosis (outlook).
The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many people live much longer than 5 years (and many are cured). Although many patients live much longer than this, it isn't always an indication that the cancer has been cured, as some thymus tumors are very slow growing, and others may return in some people several years after treatment.
So below is a rough idea of survival rates in thymoma.
However no one can predict how long a child can live even after successful treatment due to the chances of recurrence. Its possible he may live long enough like a normal adult but the risk of recurrence or complications during or after treatment will determine the actual survival.
The five-year survival rates for thymomas are 96% for stage I, 86% for stage II, 69% for stage III, and 50% for stage IV. Thorough (radical) surgery is associated with a longer survival rate. Almost 15% of thymoma patients develop a second cancer.

I understand your concern for the child and I would advise you not to give up hope though the numbers might be frightening. When the patient and his family fight against cancer with a positive attitude the outcome is many a times surprisingly good.
So never give up and hope for the best .
Hope that answers your query.
Above answer was peer-reviewed by
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