ITMIG consensus statement on the use of the WHO Histological classification of thymoma and thymic carcinoma

Refined definitions, histological criteria, and Reporting

Alexander Marx, Philipp Ströbel, Sunil Badve, Lara Chalabreysse, John K C Chan, Gang Chen, Laurence De Leval, Frank Detterbeck, Nicolas Girard, Jim Huang, Michael O. Kurrer, Libero Lauriola, Mirella Marino, Yoshihiro Matsuno, Thierry Jo Molina, Kiyoshi Mukai, Andrew G. Nicholson, Daisuke Nonaka, Ralf Rieker, Juan Rosai & 2 others Enrico Ruffini, William D. Travis

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

INTRODUCTION:: The 2004 version of the World Health Organization classification subdivides thymic epithelial tumors into A, AB, B1, B2, and B3 (and rare other) thymomas and thymic carcinomas (TC). Due to a morphological continuum between some thymoma subtypes and some morphological overlap between thymomas and TC, a variable proportion of cases may pose problems in classification, contributing to the poor interobserver reproducibility in some studies. METHODS:: To overcome this problem, hematoxylin-eosin-stained and immunohistochemically processed sections of prototypic, "borderland," and "combined" thymomas and TC (n = 72) were studied by 18 pathologists at an international consensus slide workshop supported by the International Thymic Malignancy Interest Group. RESULTS:: Consensus was achieved on refined criteria for decision making at the A/AB borderland, the distinction between B1, B2, and B3 thymomas and the separation of B3 thymomas from TCs. "Atypical type A thymoma" is tentatively proposed as a new type A thymoma variant. New reporting strategies for tumors with more than one histological pattern are proposed. CONCLUSION:: These guidelines can set the stage for reproducibility studies and the design of a clinically meaningful grading system for thymic epithelial tumors.

Original languageEnglish
Pages (from-to)596-611
Number of pages16
JournalJournal of Thoracic Oncology
Volume9
Issue number5
DOIs
StatePublished - 2014

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Thymoma
Consensus
Consensus Development Conferences
Public Opinion
Hematoxylin
Eosine Yellowish-(YS)
Neoplasms
Decision Making
Guidelines

Keywords

  • Diagnostic criteria
  • Histological classification
  • Thymic carcinoma
  • Thymoma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Oncology
  • Medicine(all)

Cite this

ITMIG consensus statement on the use of the WHO Histological classification of thymoma and thymic carcinoma : Refined definitions, histological criteria, and Reporting. / Marx, Alexander; Ströbel, Philipp; Badve, Sunil; Chalabreysse, Lara; Chan, John K C; Chen, Gang; De Leval, Laurence; Detterbeck, Frank; Girard, Nicolas; Huang, Jim; Kurrer, Michael O.; Lauriola, Libero; Marino, Mirella; Matsuno, Yoshihiro; Molina, Thierry Jo; Mukai, Kiyoshi; Nicholson, Andrew G.; Nonaka, Daisuke; Rieker, Ralf; Rosai, Juan; Ruffini, Enrico; Travis, William D.

In: Journal of Thoracic Oncology, Vol. 9, No. 5, 2014, p. 596-611.

Research output: Contribution to journalArticle

Marx, A, Ströbel, P, Badve, S, Chalabreysse, L, Chan, JKC, Chen, G, De Leval, L, Detterbeck, F, Girard, N, Huang, J, Kurrer, MO, Lauriola, L, Marino, M, Matsuno, Y, Molina, TJ, Mukai, K, Nicholson, AG, Nonaka, D, Rieker, R, Rosai, J, Ruffini, E & Travis, WD 2014, 'ITMIG consensus statement on the use of the WHO Histological classification of thymoma and thymic carcinoma: Refined definitions, histological criteria, and Reporting', Journal of Thoracic Oncology, vol. 9, no. 5, pp. 596-611. https://doi.org/10.1097/JTO.0000000000000154
Marx, Alexander ; Ströbel, Philipp ; Badve, Sunil ; Chalabreysse, Lara ; Chan, John K C ; Chen, Gang ; De Leval, Laurence ; Detterbeck, Frank ; Girard, Nicolas ; Huang, Jim ; Kurrer, Michael O. ; Lauriola, Libero ; Marino, Mirella ; Matsuno, Yoshihiro ; Molina, Thierry Jo ; Mukai, Kiyoshi ; Nicholson, Andrew G. ; Nonaka, Daisuke ; Rieker, Ralf ; Rosai, Juan ; Ruffini, Enrico ; Travis, William D. / ITMIG consensus statement on the use of the WHO Histological classification of thymoma and thymic carcinoma : Refined definitions, histological criteria, and Reporting. In: Journal of Thoracic Oncology. 2014 ; Vol. 9, No. 5. pp. 596-611.
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abstract = "INTRODUCTION:: The 2004 version of the World Health Organization classification subdivides thymic epithelial tumors into A, AB, B1, B2, and B3 (and rare other) thymomas and thymic carcinomas (TC). Due to a morphological continuum between some thymoma subtypes and some morphological overlap between thymomas and TC, a variable proportion of cases may pose problems in classification, contributing to the poor interobserver reproducibility in some studies. METHODS:: To overcome this problem, hematoxylin-eosin-stained and immunohistochemically processed sections of prototypic, {"}borderland,{"} and {"}combined{"} thymomas and TC (n = 72) were studied by 18 pathologists at an international consensus slide workshop supported by the International Thymic Malignancy Interest Group. RESULTS:: Consensus was achieved on refined criteria for decision making at the A/AB borderland, the distinction between B1, B2, and B3 thymomas and the separation of B3 thymomas from TCs. {"}Atypical type A thymoma{"} is tentatively proposed as a new type A thymoma variant. New reporting strategies for tumors with more than one histological pattern are proposed. CONCLUSION:: These guidelines can set the stage for reproducibility studies and the design of a clinically meaningful grading system for thymic epithelial tumors.",
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T1 - ITMIG consensus statement on the use of the WHO Histological classification of thymoma and thymic carcinoma

T2 - Refined definitions, histological criteria, and Reporting

AU - Marx, Alexander

AU - Ströbel, Philipp

AU - Badve, Sunil

AU - Chalabreysse, Lara

AU - Chan, John K C

AU - Chen, Gang

AU - De Leval, Laurence

AU - Detterbeck, Frank

AU - Girard, Nicolas

AU - Huang, Jim

AU - Kurrer, Michael O.

AU - Lauriola, Libero

AU - Marino, Mirella

AU - Matsuno, Yoshihiro

AU - Molina, Thierry Jo

AU - Mukai, Kiyoshi

AU - Nicholson, Andrew G.

AU - Nonaka, Daisuke

AU - Rieker, Ralf

AU - Rosai, Juan

AU - Ruffini, Enrico

AU - Travis, William D.

PY - 2014

Y1 - 2014

N2 - INTRODUCTION:: The 2004 version of the World Health Organization classification subdivides thymic epithelial tumors into A, AB, B1, B2, and B3 (and rare other) thymomas and thymic carcinomas (TC). Due to a morphological continuum between some thymoma subtypes and some morphological overlap between thymomas and TC, a variable proportion of cases may pose problems in classification, contributing to the poor interobserver reproducibility in some studies. METHODS:: To overcome this problem, hematoxylin-eosin-stained and immunohistochemically processed sections of prototypic, "borderland," and "combined" thymomas and TC (n = 72) were studied by 18 pathologists at an international consensus slide workshop supported by the International Thymic Malignancy Interest Group. RESULTS:: Consensus was achieved on refined criteria for decision making at the A/AB borderland, the distinction between B1, B2, and B3 thymomas and the separation of B3 thymomas from TCs. "Atypical type A thymoma" is tentatively proposed as a new type A thymoma variant. New reporting strategies for tumors with more than one histological pattern are proposed. CONCLUSION:: These guidelines can set the stage for reproducibility studies and the design of a clinically meaningful grading system for thymic epithelial tumors.

AB - INTRODUCTION:: The 2004 version of the World Health Organization classification subdivides thymic epithelial tumors into A, AB, B1, B2, and B3 (and rare other) thymomas and thymic carcinomas (TC). Due to a morphological continuum between some thymoma subtypes and some morphological overlap between thymomas and TC, a variable proportion of cases may pose problems in classification, contributing to the poor interobserver reproducibility in some studies. METHODS:: To overcome this problem, hematoxylin-eosin-stained and immunohistochemically processed sections of prototypic, "borderland," and "combined" thymomas and TC (n = 72) were studied by 18 pathologists at an international consensus slide workshop supported by the International Thymic Malignancy Interest Group. RESULTS:: Consensus was achieved on refined criteria for decision making at the A/AB borderland, the distinction between B1, B2, and B3 thymomas and the separation of B3 thymomas from TCs. "Atypical type A thymoma" is tentatively proposed as a new type A thymoma variant. New reporting strategies for tumors with more than one histological pattern are proposed. CONCLUSION:: These guidelines can set the stage for reproducibility studies and the design of a clinically meaningful grading system for thymic epithelial tumors.

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