Multilocular thymic cyst detected during coronary artery bypass surgery

Öz

Thymic cyts that are located in the mediastinal space are rarely seen and forms 1-3% of all the mediastinal masses. They may be congenital or acquired. During the coronary artery surgery of 54 years old male patient, 14x4 cm and 13x3 cm sized masses were detected at the anterior mediastinum. The masses were thick walled and had multicystic apperance. After the median sternotomy, all thymic cysts were resected then coronary artery bypass surgery was performed. The histopathologic examination was diagnosed as acquired multilocular thymic cysts and lymhoid hyperplasia. Thymic masses can be accidentally seen during median sternotomy for coronary artery bypass surgery, we think that removal of these masses are necessary and beneficial.

Anahtar Kelimeler

• Multiloculer thymic cysts, coronary artery bypass graft surgery, malignancy

Koroner arter bypass operasyonu sırasında rastlanılan multiloküler timik kist

Öz

Mediastinal yerleşimli timik kistler nadir olup, tüm mediasten kitlelerinin %1-3\'ünü oluşturur. Kistler doğuştan veya akkiz olabilir. Koroner arter hastalığı tanısıyla operasyonu yapılan 54 yaşındaki erkek hastada cerrahi işlem sırasında 14x4 cm ve 13x3 cm boyutunda iki adet anterior mediastinal kitle saptandı. Kitleler, kalın duvarlı ve multipl kistik görünümdeydi. Median sternotomi sonrası her iki timik yapı tümüyle çıkarıldıktan sonra hastaya koroner arter bypass operasyonu uygulandı. Histopatolojik incelemede edinsel multiloküler timik kist ve lenfoid hiperplazi tanısı kondu. Koroner arter bypass operasyonu için yapılan sternotomide timik kistlerle karşılaşıldığında, kitle eksizyonunun yararlı ve gerekli olduğu kanaatindeyiz.

Anahtar Kelimeler

• Multiloküler timus kisti, koroner arter bypass cerrahisi, malignite

Kaynakça

1. Brown LR, Aughenbaugh GL. Masses of the anterior me- diastinum: CT and MR imaging. AJR Am J Roentgenol 1991:1171-1180.
2. Suster S, Rosai J. Multilocular thymic cyst: an acquired reactive process. Study of 18 cases. Am J Surg Pathol 1991:388-398.
3. Ulutaş H, Kuzucu A. İleri yaşta saptanan konjenital timik kist olgusu: nadir bir antite. İnönü Üniversitesi Tıp Fakülte- si Dergisi 2010:123-125.
4. Chhieng DC, Demaria S, Yee HT, Yang GC. Multilocular thymic cyst with follicular lymphoid hyperplasia in a male infected with HIV. A case report with fine needle aspiration cytology. Acta Cytol 1999:1119-1123.
5. Rieker RJ, Aulmann S, Schnabel PA, Sack FU, Otto HF, Mechtersheimer G. Cystic thymoma. Pathol Oncol Res 2005:57-60.
6. Ertuğrul M, Bayrem Selvi Ü, Damadoğlu E, ve ark. Timik kistler: altı olgu nedeniyle. Tüberküloz ve Toraks Dergisi 2006:172-176.
7. Wick MR. Mediastinal cysts and intrathoracic thyroid tu- mors. Semin Diagn Pathol 1990:285-294.
8. Choi YW, McAdams HP, Jeon SC, et al. Idiopathic multiloc- ular thymic cyst: CT features with clinical and histopatho- logic correlation. AJR Am J Roentgenol 2001:881-885.

9. Saito Y, Murai K, Kawai Y, et al. Spontaneous hemorrhage of a thymic cyst in an adult: report of a case. Surg Today 2010:958-962.