INTRAPERICARDIAL THYMOMA - REPORT OF 2 INCIDENTAL AUTOPSY CASES AND REVIEW OF THE LITERATURE

Objectives.-To report the pathologic features of intrapericardial thym oma and discuss their possible clinical relevance. Design.-Retrospecti ve evaluation of autopsy cases and the available clinical records. Set ting.-A large autopsy population (>31 000 postmortem examinations betw een 1980 and 1995) in an Italian general hospital. Results.-Two cases of thymoma showing an exclusive intrapericardial growth were retrieved from autopsy files. The patients were 61 and 82 years of age, both we re women, and both were referred to the hospital with terminal conditi ons due to either neoplastic or chronic diseases. Myasthenia gravis an d/or immunologic dysfunctions were not noted, although one of the pati ents had serum hypogammaglobulinemia. Roentgenography showed enlargeme nt of mediastinal profiles and suggested cardiomegaly. At autopsy, tum ors were bulky, noninvasive, and from 6 to 10 cm in largest dimension. Histologically, they were spindle cell ''medullary'' thymomas, freque ntly showing cell arrangement around microcystic spaces. They were str ongly immunoreactive for epithelial markers. Conclusions.-This study c onfirms that thymomas may occur in the pericardium, Tumor-related symp toms may be overlooked owing to concomitant heart disease or equivocal instrumental features, especially in the absence of immune system dis turbances. Based on these premises, they may deserve a specific distin ction in the expanding chapter of ectopic thymomas.