A 70-year-old woman presented with increasing shortness of breath of several weeks duration. Further work-up revealed a large mass located in the thymus, which was surgically resected. The resected mass weighed 144 g, measured 21.0 cm in greatest dimension and on sectioning had a predominantly uniform tan appearance with focal areas of calcifications. The light microscopic appearance of the mass prompted immunohistochemical studies and the pertinent results are as follows: The lesional cells were negative for cytokeratin AE1/AE3, CK19, p63, CD5 and CD117. They showed focal cytoplasmic staining for CD21and strong positivity for CD35 and D2-40.
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• Follicular dendritic cell sarcoma
• Nodular sclerosis classical Hodgkin lymphoma
• Primary mediastinal large B-cell lymphoma
• Spindle cell thymoma
• Thymic carcinoma (spindle cell variant)
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• Appropriate diagnosis
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