Type A thymoma: a rare cause of neoplastic cardiac tamponade with long-term survival

Figures

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  Fig. 1. Radiological findings. a, b A large amount of pericardial fluid and bilateral pleural effusion. c, d A tumor with calcification in the anterior mediastinum extending into the pericardial inner lumen. e A contrast-enhanced tumor in the anterior mediastinum during drainage

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  Fig. 2. Cytology of pericardial fluid (Papanicolaou stain, × 400) (a) and histology of a biopsy specimen (Hematoxylin and eosin stain, × 200) (b). a Pericardial fluid showing an aggregate of atypical cells and inflammatory cells (mainly neutrophils). Atypical cells contain large nuclei with poor chromatin enrichment, relatively prominent nucleoli and abundant cytoplasm. b Spindle-shaped and oval epithelial cells with low-grade dysplasia arranged in pseudo-rosettes or short fascicles admixed with few lymphocytes. The sections were observed with a microscope: BX53 (OLYMPUS, Tokyo, Japan), lenses: UPlanFl (OLYMPUS, Tokyo, Japan), a camera: DP22 (OLYMPUS, Tokyo Japan), and a photo system: cellSens Standard 2.3 (OLYMPUS, Tokyo Japan) at a resolution of 96 dots per inch (1920 × 1440 pixels). The scale bar is 50 μm (a) or 100 μm (b)

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  Fig. 3. Dorsal view of a formalin-fixed resected specimen (a) and histology (b–e) (Hematoxylin and eosin stain: b, × 400; c–e, × 40). a A tumor (white arrow) extending into the pericardial inner lumen (white arrowhead: pericardium). b Type A thymoma showing the same morphology as at the time of biopsy. c–e Tumor cell invasion into the pericardium (white arrow). b Microscope: BX53 (OLYMPUS, Tokyo, Japan), lenses: UPlanFl (OLYMPUS, Tokyo, Japan), a camera: DP22 (OLYMPUS, Tokyo Japan), and a photo system: cellSens Standard 2.3 (OLYMPUS, Tokyo Japan) at a resolution of 96 dots per inch (1920 × 1440 pixels). The scale bar = 50 μm. c–e Microscope: AX80 (OLYMPUS, Tokyo, Japan), lenses: UPlanApo (OLYMPUS, Tokyo, Japan), a camera: DP70 (OLYMPUS, Tokyo Japan), and a photo system: DP controller 1.2 (OLYMPUS, Tokyo Japan) at a resolution of 72 dots per inch (4080 × 3072 pixels). The scale bar = 1 mm