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Title: Ectopic cervical thymus: A clinicopathological study of consecutive, unselected infant autopsies
Authors: Kotani, Hirokazu  kyouindb  KAKEN_id
Ishida, Tokiko
Miyao, Masashi  kyouindb  KAKEN_id
Manabe, Sho
Kawai, Chihiro
Abiru, Hitoshi
Omae, Tadaki
Osamura, Toshio
Tamaki, Keiji  kyouindb  KAKEN_id
Author's alias: 小谷, 泰一
Keywords: Ectopic cervical thymus
Natural incidence
Clinical course
Sudden unexpected death in infancy
Congenital anomaly
Issue Date: Nov-2014
Publisher: Elsevier Ireland Ltd.
Journal title: International Journal of Pediatric Otorhinolaryngology
Volume: 78
Issue: 11
Start page: 1917
End page: 1922
Abstract: [Objectives] An ectopic cervical thymus (ECT) is regarded as a rare congenital anomaly; therefore, the optimal diagnostic and therapeutic strategy remains a debatable matter. We designed a study to elucidate the clinicopathological characteristics of ECTs in consecutive, unselected infant autopsies, to help guide case management. [Methods]We searched for ECTs in all of the 21 consecutive, unselected infant autopsy cases performed at our institution over a period of 3 years, and all ECT consensus diagnoses were confirmed by histological examination. The following clinical characteristics were evaluated in cases with ECTs: age, gender, birth week and weight, clinical symptoms due to the ECT(s), position on discovery of death, cause of death, ECT contribution to the cause of death, and concomitant congenital disorders. The anatomical features evaluated included the location, number, size, color, shape, and margins of the ECTs, and the presence of a mediastinal thymus. Histological findings of the ECT(s) and the mediastinal thymus were compared within each individual. Fusion of the parathyroid and the ECT was also investigated histologically. Spearman's rank correlation coefficient (ρ) and the corresponding P value were calculated to determine if there was an association between ECT diameter and age. [Results]We detected 10 ECT lesions in seven cases (33%) among the 21 infant autopsy cases. The ECT cases involved five boys and two girls, with ages ranging from 1 day to 4 months. There were no reports of a positive family history of sudden death or antemortem clinical symptoms due to ECT in any of the cases. The ECTs were considered incidental regarding the cause of death, with the exception of one case that was extremely rare. Most ECTs were localized to the inferior thyroid, ranging from 0.4 to 1.9 cm in size. Size demonstrated a significant negative correlation with age (ρ = −0.75 and P = 0.034). [Conclusions]This study revealed that ECT is an essentially benign anomaly that occurs frequently during the development of the thymus, and may disappear over the first few years of life. These results suggest a conservative approach to the management of ECTs would be appropriate.
Rights: © 2014 Elsevier Ireland Ltd.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1016/j.ijporl.2014.08.024
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