WHO胸腺和纵隔肿瘤组织学分类（2015版）

阳光肺科 · 发表于 2020-9-8 18:56:01

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胸腺瘤WHO组织学分类由Rosai领导的专家组于1999年公布的， 2004年修订，为目前应用最广泛的胸腺肿瘤组织学分类法。2015年再次修订WHO胸腺和纵隔肿瘤组织学分类2015版。

上皮源性肿瘤Epithelial tumours

1. 胸腺瘤Thymoma

1.1. A型，包括不典型的变异型Type A thymoma, including atypical variant

1.2. AB型Type AB thymoma

1.3. B1型Type B1 thymoma

1.4. B2型Type B2 thymoma

1.5. B3型Type B3 thymoma

1.6. 微结节胸腺瘤伴淋巴样间质瘤Micronodular thymoma with lymphoid stroma

1.7. 化生性胸腺瘤Metaplastic thymoma

1.8. 其他少见的胸腺瘤Other rare thymomas

1.8. 1 微小胸腺瘤Microscopic thymoma

1.8. 2 硬化性胸腺瘤Sclerosing thymoma

1.8. 3 脂肪纤维腺瘤Lipofibroadenoma

2. 胸腺癌Thymic carcinoma

2. 1 鳞状细胞癌 Squamous cell carcinoma

2. 2 基底细胞样癌 Basaloid carcinoma

2. 3 粘液表皮样癌 Mucoepidermoid carcinoma （MEC）

2. 4 淋巴上皮瘤样癌ymphoepithelioma-like carcinoma

2. 5 透明细胞癌Clear cell carcinoma

2. 6 肉瘤样癌 Sarcomatoid carcinoma

2. 7 腺癌 Adenocarcinomas

2. 7.1 乳头状腺癌Papillary adenocarcinoma

2. 7.2 胸腺癌伴腺样囊性癌样特征Thymic carcinoma with adenoid cystic carcinoma-like features

2. 7.3 黏液腺癌Mucinous adenocarcinoma

2. 7.4 腺癌，NOS Adenocarcinoma, NOS

2.8 NUT癌 NUT carcinoma

2.9 未分化癌 Undifferentiated carcinoma

2.10 其他少见胸腺癌Other rare thymic carcinomas

2.10.1 腺鳞癌Adenosquamous carcinoma

2.10.2 肝样癌Hepatoid carcinoma

2.10.3 胸腺癌，NOS Thymic carcinoma, NOS

3. 胸腺内分泌肿瘤Thymic neuroendocrine tumours

3.1 类癌Carcinoid tumours

3.1.1 典型类癌Typical carcinoid

3.1.2 不典型类癌Atypical carcinoid

3.2 大细胞神经内分泌癌Large cell neuroendocrine carcinoma

3.2.1 混合型大细胞神经内分泌癌Combined large cell neuroendocrine carcinoma

3.3 小细胞肺癌Small cell carcinoma

3.3.1 混合型小细胞肺癌Combined small cell carcinoma

4. 混合性胸腺癌Combined thymic carcinomas

4.1 混合型胸腺癌Combined thymic carcinomas

纵隔生殖细胞瘤Germ cell tumours of the mediastinum

1. 精原细胞瘤Seminoma

2. 胚胎癌Embryonal carcinoma

3. 卵黄囊肿瘤Yolk sac tumour

4. 绒毛膜癌Choriocarcinoma

5. 畸胎瘤Teratoma

5.1 畸胎瘤，成熟 Teratoma, mature

5.2 畸胎瘤，不成熟 Teratoma, immature

6. 混合型生殖细胞瘤 Mixed germ cell tumours

7. 生殖细胞瘤伴体细胞型固体肿瘤 Germ cell tumours with somatic-type solid malignancy

8. 生殖细胞瘤伴相关血液恶性疾病 Germ cell tumours with associated haematological malignancy

纵隔淋巴瘤 Lymphomas of the mediastinum

1. 原发性纵隔大b细胞淋巴瘤Primary mediastinal large B-cell lymphoma

2. 边缘区淋巴瘤黏膜相关淋巴组织Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)

3. 其他成熟的B细胞淋巴瘤Other mature B-cell lymphomas

4. T淋巴细胞性白血病淋巴瘤T lymphoblastic leukaemia lymphoma

5. 间变性大细胞淋巴瘤(ALCL)和其他罕见的成熟T亚群和NK细胞淋巴瘤Anaplastic large cell lymphoma (ALCL) and other rare mature T- and NK-cell lymphomas

(1)ALK阳性，ALCL, ALK-positive (ALK+)

(2)ALK阴性，ALCL, ALK-negative (ALK-)

6. 霍奇金淋巴瘤Hodgkin lymphoma

7. B细胞淋巴瘤，不能分类，具有弥漫性大B细胞和经典霍奇金淋巴瘤的共同特征B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell and Classical Hodgkin lymphoma

纵隔组织细胞和树突状细胞肿瘤Histiocytic and dendritic cell neoplasms of the mediastinum

1.郎罕氏细胞病变Langerhans cell lesions

(1) 胸腺细胞性组织细胞增生症Thymic Langerhans cell histiocytosis

(2) 朗格汉斯细胞肉瘤Langerhans cell sarcoma

2. 组织细胞肉瘤Histiocytic sarcoma

3. 滤泡树突细胞肉瘤Follicular dendritic cell sarcoma

4. 指突状树突细胞肉瘤Interdigitating dendritic cell sarcoma

5. 成纤维网状细胞瘤Fibroblastic reticular cell tumour

6. 不确定树突状细胞肿瘤Indeterminate dendritic cell tumour

髓样肉瘤和髓外急性髓样白血病Myeloid sarcoma and extramedullary acute myeloid leukaemia

1. 髓样肉瘤和髓外急性髓样白血病Myeloid sarcoma and extramedullary acute myeloid leukaemia

纵隔软组织肿瘤Soft tissue tumours of the mediastinum

1. 胸腺脂肪瘤Thymolipoma

2. 脂肪瘤Lipoma

3. 脂肪肉瘤Liposarcoma

(1) 分化良好型Well-differentiated

(2) 去分化型Dedifferentiated

(3) 黏液样型Myxoid

(4) 多形性型Pleomorphic

4. 孤立性纤维性肿瘤Solitary fibrous tumour

(1)恶性Malignant

5. 滑膜肉瘤Synovial sarcoma

(1) 滑膜肉瘤Synovial sarcoma, NOS

(2) 滑膜肉瘤, 梭形细胞 Synovial sarcoma, spindle cell

(3) 滑膜肉瘤, 类上皮细胞 Synovial sarcoma, epithelioid cell

(4) 滑膜肉瘤, 双相 Synovial sarcoma, biphasic

6. 血管，肿瘤Vascular, neoplasms

(1) 淋巴管瘤 Lymphangioma

(2) 血管瘤 Haemangioma

(3) 上皮样血管内皮瘤Epithelioid hemangioendothelioma

(4) 血管肉瘤Angiosarcoma

7. 神经源性肿瘤 Neurogenic tumours

(1) 周围神经瘤 Tumours of peripheral nerves

(2) 神经节细胞瘤Ganglioneuroma

(3) 神经节母细胞瘤Ganglioneuroblastoma

(4) 神经母细胞瘤Neuroblastoma

胸腺异位瘤Ectopic tumours of the thymus

1. 异位甲状腺肿瘤Ectopic thyroid tumours

2. 异位甲状旁腺肿瘤Ectopic parathyroid tumours

3. 其他少见的异位肿瘤Other rare ectopic tumours

【参考文献】

Kondo K, Yoshizawa K, Tsuyuguchi M, et al. WHO histologicclassification is a prognostic indicator in thymoma. Ann Thorac Surg2004;77:1183-1188.
Travis, W.D., Brambilla, E., Burke, A.P., Marx, A.,Nicholson, A. G. WHO Classification of Tumours of the Lung, Pleura, Thymus andHeart. Fourth edition. 2015

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Wen · 发表于 2021-8-10 19:47:03