Main Article Content
Abstract
Thymic tissue ectopia was more commonly identified by morphologists at the beginning of the 20th century, but publications about the significance of these inclusions appeared only in the 21st century. With the improvement of diagnostic technologies, previously considered as rudimentary foci, ectopic areas of the thymus began to be considered as part of a full-fledged organ, which are equally invaluable for the formation of the immune system. This review considers modern ideas about embryogenesis, prevalence, diagnosis and clinical significance of thymus ectopia both in healthy children and those who underwent thymectomy due to surgery for congenital heart defects.
Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Kacker A, April M, Markentel CB, Breuer F. Ectopic thymus presenting as a solid submandibular neck mass in an infant: case report and review of literature. Internat J of Pediat Otorhinolaryngol. 1999; 49(3): 241-245
Walter E, Willich E, Webb WR. The thymus: Diagnostic Imaging, Functions, and Pathological Anatomy. Berlin Heidelberg: Springer, 1992. 224 p.
Wee T, Lee AF, Nadel H, Bray H. The paediatric thymus: recognising normal and ectopic thymic tissue. Clin Radiol. 2021; 76(7): 477-487. DOI: 10.1016/j.crad.2021.02.017
Kim HG, Kim MJ, Lee MJ. Sonographic appearance of intrathyroid ectopic thymus in children. J Clin Ultrasound. 2012; 40(5): 266-271. DOI: 10.1002/jcu.21898
Bang MH, Shin J, Lee KS, Kang MJ. Intrathyroidal ectopic thymus in children: a benign lesion. Medicine (Baltimore). 2018; 97(14): e0282. DOI: 10.1097/MD.0000000000010282
Klimek-Piotrowska W, Mizia E, Kuzdza1 J, Lazar A, Lis M, Pankowski J. Ectopic thymic tissue in the mediastinum: limitations for the operative treatment of myasthenia gravis. Eur J Cardiothorac Surg. 2012; 42(1): 61-65. DOI: 10.1093/ejcts/ezr268
Tabatabaie SA, Hashemi SM, Sanei B, Sanei MH. The frequency of ectopic thymic tissue in the necks of patients without any thymic disease. Med Sci Monit. 2007; 13(6): CR283-85
Erol OB, Sahin D, Bayramoglu Z, Yılmaz R, Akpınar YuE, Ünal ÖF, Yekeler E. Ectopic intrathyroidal thymus in children: prevalence, imaging findings and evolution. Turk J Pediatr. 2017; 59(4): 387e94. DOI: 10.24953/turkjped.2017.04.004
Costa NS, Laor T, Donnelly LF. Superior cervical extension of the thymus: a normal finding that should not be mistaken for a mass. Radiology. 2010; 256(1): 238-242. DOI: 10.1148/radiol.10091792
Kotani H, Ishida T, Miyao M, Manabe S, Kawai C, Abiru H, et al. Ectopic cervical thymus: a clinicopathological study of consecutive, unselected infant autopsies. Int J Pediatr Otorhinolaryngol. 2014; 78(11): 1917-1922. DOI: 10.1016/j.ijporl.2014.08.024
Fukushima T, Suzuki S, Ohira T, Shimura H, Midorikawa S, Ohtsuru A, et al. Prevalence of ectopic intrathyroidal thymus in Japan: the Fukushima health management survey. Thyroid. 2015; 25(5): 534-537. DOI: 10.1089/thy.2014.0367
Ponseti JM, Gamez J, Vilallonga R, Ruiz C, Azem J, López-Cano M, Armengol M. Influence of ectopic thymic tissue on clinical outcome following extended thymectomy in generalized seropositive nonthymomatous myasthenia gravis. Eur J Cardiothorac Surg. 2008; 34(5): 1062-1067. DOI: 10.1016/j.ejcts.2008.07.049
Zieliński M, Kuzdzał J, Szlubowski A, Soja J. Transcervical-subxiphoid-videothoracoscopic «maximal» thymectomy-operative technique and early results. Ann Thorac Surg. 2004; 78(2): 404-9; discussion 409-410. DOI: 10.1016/j.athoracsur.2004.02.021
Ashour M. Prevalence of ectopic thymic tissue in myasthenia gravis and its clinical significance. J Thorac Cardiovasc Surg. 1995; 109(4): 632-635. DOI: 10.1016/S0022-5223(95)70343-8
Abakir N, Eravcı FC, Emlik GD. Symptomatic solid ectopic cervical thymus in a 2-month-old infant: case report. Turk Arch Otorhinolaryngol. 2021; 59: 154-157. DOI: 10.4274/tao.2021.2021-2-16
González AMH, Rivera DM, Peralta MP. Ectopic cervical thymus: a case report. Rev Colomb Radiol. 2018; 29(3): 4975-4978
Nguyen Q, deTar M, Wells W, Crockett D. Cervical thymic cyst: case reports and review of the literature. Laryngoscope. 1996; 106: 247-252. DOI: 10.1097/00005537-199603000-00001
Alnosair AA, Alnosair LA, Saleh AAA, Al Zaid AR, Al Alhareth AS, Alkhars FS. Solid Ectopic Cervical Thymus: A Case Report. Cureus. 2022; 14(5): e25142. DOI: 10.7759/cureus.25142
Makogon AV, Andryushina IV, Chernova DA. Right ventricular aneurysm. Ectohic thymus in the right ventricle of fetal heart. Prenatal Diagnosis. 2017; 16(2): 133-140. Russian (Макогон А.В., Андрюшина И.В., Чернова Д.А. Аневризма правого желудочка плода. Эктопия тимуса в миокард правого желудочка //Пренатальная диагностика. 2017. Т. 16, № 2. С. 133-140.) DOI: 10.21516/2413-1458-2017-16-2-133-140
Lin Y, Li J, Xue L, Sun P, He Q, Li Y. Ectopic thymic tissue in subglottis of children: evaluation and management. Braz J Otorhinolaryngol. 2023; 89(1): 90-97. DOI: 10.1016/j.bjorl.2021.10.001
O'Connor K, Alzahrani H, Murad F, Daroca P, Kandil E. An ectopic intrathyroidalthymic tissue and intrathymic parathyroid tissue in a patient with Graves disease. Gland Surg. 2017; 6(6): 726-728. DOI: 10.21037/gs.2017.08.11
Chen C, Liu BB, Bian PP, Xu BC, Guo YF. Pharyngeal ectopic thymus: a case report. Ear Nose Throat J. 2021; 100: NP354-356. DOI: 10.1177/0145561320918434
Segni M, di Nardo R, Pucarelli I, Biffoni M. Ectopic intrathyroidal thymus in children: a long-term follow-up study. Horm Res Paediatr. 2011; 75(4): 258-263. DOI: 10.1159/000322441
Kabaalioğlu A, Öztek MA, Kesimal U, Çeken K, Durmaz E, Apaydın A. Intrathyroidal ectopic thymus in children: a sonographic survey. Med Ultrason. 2017; 19(2): 179-184. DOI: 10.11152/mu-913
Kancherla VS, Foster SB, Holsinger C, Luna M, Jones J, Hanson C. Characterization of Immune Function in a Patient with Ectopic Thymus. J All Clin Immunol. 2006; 117(2): S288. DOI: 10.1016/j.jaci.2005.12.1087
Chang A, Nataraja RM, Pudel E, Stunden R, Baré S, Pacilli M. Diagnosis and management of ectopic cervical thymus in children: Systematic review of the literature. J Pediatr Surg. 2021; 56: 2062-2068. DOI: 10.1016/j.jpedsurg.2021.03.003
Pani E, Cantone N, Naselli A, Noccioli B, Ciardini E. New-born with cervical ectopic thymus: an uncommon developmental disorder which has to be consider in the differential diagnosis of unilateral neck mass in children. Acad J Ped Neonatol. 2020; 9(1): 555809. DOI: 10.19080/ajpn.2020.09.555809
Loney DA, Bauman NM. Ectopic cervical thymic masses in infants: a case report and review of the literature. Int J Pediatr Otorhinolaryngol. 1998; 43(1): 77-84. DOI: 10.1016/s0165-5876(97)00155-9
Al-Salem AH. Ectopic thymic tissue simulating--a posterior mediastinal mass. Eur J Pediatr Surg. 1992; 2(2): 106-7. DOI: 10.1055/s-2008-1063414
Malone PS, Fitzgerald RJ. Aberrant thymus: a misleading mediastinal mass. J Pediatr Surg. 1987; 22(2): 130-131. DOI: 10.1016/s0022-3468(87)80428-1
Panferova TR, Nilulina AL, Serebryakova IN, Polyakov VG. The ultrasound diagnosis of ectopic thymus tissue in the thyroid gland in children. Onkopediatria. 2015; 2(2): 109-114. Russian (Панфёрова Т.Р., Никулина А.Л., Серебрякова И.Н., Поляков В.Г. Ультразвуковая диагностика эктопированной ткани тимуса в щитовидной железе у детей //Онкопедиатрия. 2015. Т. 2, № 2. С. 109-114.) DOI: 10.15690/onco.v2i2.1341
Wells WJ, Parkman R, Smogorzewska E, Barr M. Neonatal thymectomy: does it affect immune function? J Thorac Cardiovasc Surg. 1998; 115(5): 1041-1046. DOI: 10.1016/S0022-5223(98)70403-9
Afifi A, Raja SG, Pennington DJ, Tsang VT. For neonates undergoing cardiac surgery does thymectomy as opposed to thymic preservation have any adverse immunological consequences? Interact Cardiovasc Thorac Surg. 2010; 11(3): 287-291. DOI: 10.1510/icvts.2010.237172
Halnon NJ, Jamieson B, Plunkett M, Kitchen CM, Pham T, Krogstad P. Thymic function andrimpaired maintenance of peripheral T-cell populations in children with congenital heart disease and surgicalthymectomy. Pediatr Res. 2005; 57: 42-48
Sauce D, Larsen М, Fastenackels S, et al. Evidence of premature immune aging in patients thymectomized during early childhood. J Clin Invest. 2009; 119: 3070-3078
Torfadottir H, Freysdottir J, Skaftadottir I, Haraldsson A, Sigfiisson G, Ogmundsdottir HM. Evidence for extrathymic T-cell maturation afterthymectomy in infancy. Clin Exp Immunol. 2006; 145(3): 407-412
Cavalcanti NV, Palmeira P, Jatene MB, de Barros Dorna M, Carneiro-Sampaio M. Early Thymectomy Is Associated With Long-Term Impairment of the Immune System: A Systematic Review. Front Immunol. 2021; 12: 774780. DOI: 10.3389/fimmu.2021.774780