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Non-Neoplastic and Benign Tumoral Lesions of the Thymic Gland

A Review and Update

Hamza, Ameer, MD; Weissferdt, Annikka, MD, FRCPath

Advances in Anatomic Pathology: July 2019 - Volume 26 - Issue 4 - p 257–269
doi: 10.1097/PAP.0000000000000231
Review Articles

The thymus is a dynamic organ that undergoes changes throughout life and can demonstrate a myriad of pathologic alterations. A number of benign entities of the thymus prove to be diagnostic dilemmas owing to their resemblance and association with true thymic tumors. These are usually discovered incidentally on routine imaging and most patients are either asymptomatic or present with signs and symptoms of compression of adjacent organs. The radiologic appearance of these lesions varies from simple cysts to complex masses that are suspicious for malignancy. The diagnosis is usually made purely on morphologic grounds, however, immunohistochemical stains can help rule out possible differential diagnoses. Surgical removal is usually curative in these lesions and recurrences are rare. The prognosis is excellent, however, some of these lesions may be associated with myasthenia gravis and/or thymomas. In this review, we describe non-neoplastic lesions and benign tumoral lesions of the thymus, with emphasis on the clinical, radiologic, and pathologic features. The differential diagnosis of each entity is also discussed.

Department of Pathology, MD Anderson Cancer Center, Houston, TX

The authors have no funding or conflicts of interest to disclose.

All figures can be viewed online in color at

Reprints: Annikka Weissferdt, MD, FRCPath, Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030 (e-mail:

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