Editing Thymus (section)

====Lymphomas====

Tumours originating from T cells of the thymus form a subset of [[acute lymphoblastic leukaemia]] (ALL).<ref name="Williams9eChapter91">{{cite book |last1=Larson |first1=Richard A. | name-list-style = vanc |title=Williams hematology (online) |date=2015 |publisher=McGraw-Hill Education |isbn=978-0071833004 |edition=9th |chapter=Chapter 91: Acute Lymphoblastic Leukemia}}</ref> These are similar in symptoms, investigation approach and management to other forms of ALL.<ref name="Williams9eChapter91" /> Symptoms that develop, like other forms of ALL, relate to deficiency of [[platelet]]s, resulting in bruising or bleeding; immunosuppression resulting in infections; or infiltration by cells into parts of the body, resulting in an [[hepatomegaly|enlarged liver]], [[splenomegaly|spleen]], [[lymphadenopathy|lymph nodes]] or other sites.<ref name="Williams9eChapter91" /> Blood test might reveal a large amount of white blood cells or [[lymphoblast]]s, and deficiency in other cell lines – such as low platelets or [[anaemia]].<ref name="Williams9eChapter91" /> [[Immunophenotyping]] will reveal cells that are [[CD3 (immunology)|CD3]], a protein found on T cells, and help further distinguish the maturity of the T cells. Genetic analysis including [[karyotyping]] may reveal specific abnormalities that may influence prognosis or treatment, such as the [[Philadelphia translocation]].<ref name="Williams9eChapter91" /> Management can include multiple courses of [[chemotherapy]], [[stem cell transplant]], and management of associated problems, such as treatment of infections with [[antibiotics]], and [[blood transfusions]]. Very high white cell counts may also require [[cytoreduction]] with [[apheresis]].<ref name="Williams9eChapter91" />

Tumours originating from the small population of B cells present in the thymus lead to [[primary mediastinal large B cell lymphoma]]s.<ref name="PMLBCL2014">{{cite journal | vauthors = Dabrowska-Iwanicka A, Walewski JA | title = Primary mediastinal large B-cell lymphoma | journal = Current Hematologic Malignancy Reports | volume = 9 | issue = 3 | pages = 273–83 | date = September 2014 | pmid = 24952250 | doi = 10.1007/s11899-014-0219-0 | pmc = 4180024 }}</ref> These are a rare subtype of [[Non-Hodgkin lymphoma]], although by the activity of genes and occasionally microscopic shape, unusually they also have the characteristics of [[Hodgkin lymphoma]]s.<ref name="Williams9eChapter98"/> that occur most commonly in young and middle-aged, more prominent in females.<ref name="Williams9eChapter98"/> Most often, when symptoms occur it is because of compression of structures near the thymus, such as the [[superior vena cava syndrome|superior vena cava]] or the [[upper respiratory tract]]; when lymph nodes are affected it is often in the mediastinum and [[cervical lymph nodes|neck]] groups.<ref name="Williams9eChapter98"/> Such tumours are often detected with a [[biopsy]] that is subject to [[immunohistochemistry]]. This will show the presence of [[clusters of differentiation]], cell surface proteins – namely [[CD30]], with [[CD19]], [[CD20]] and [[CD22]], and with the absence of [[CD15]]. Other markers may also be used to confirm the diagnosis.<ref name="Williams9eChapter98">{{cite book |last1=Smith |first1=Stephen D. |last2=Press |first2=Oliver W. | name-list-style = vanc |title=Williams hematology (online) |date=2015 |publisher=McGraw-Hill Education |isbn=978-0071833004 |edition=9th |chapter=Chapter 98. Diffuse Large B-Cell Lymphoma and Related Diseases}}</ref> Treatment usually includes the typical regimens of [[CHOP (chemotherapy)|CHOP]] or [[EPOCH (chemotherapy)|EPOCH]] or other regimens; regimens generally including [[cyclophosphamide]], an [[anthracycline]], [[prednisone]], and other chemotherapeutics; and potentially also a [[stem cell transplant]].<ref name="Williams9eChapter98"/>