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Tumor tímico

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  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 12 Feb 2026
最后更新： 14 Oct 2025

小结

定义

病史和体格检查

关键诊断因素

  • miastenia gravis
  • fraqueza muscular
  • edema facial e de membros superiores
  • pletora facial
  • veias dilatadas no pescoço e parede torácica e/ou abdominal
  • edema no braço esquerdo
完整详情

其他诊断因素

  • tosse
  • dispneia
  • febre e/ou perda de peso
完整详情

危险因素

  • história de miastenia gravis
  • idade >45 anos
完整详情

诊断性检查

首要检查

  • radiografia torácica
  • tomografia computadorizada (TC) do tórax com meio de contraste intravenoso
完整详情

需考虑的检查

  • ressonância nuclear magnética (RNM) do tórax
  • biópsia tecidual
  • anticorpos contra o receptor da acetilcolina
  • Hemograma completo
  • tomografia por emissão de pósitrons/tomografia computadorizada (PET/TC)
  • alfafetoproteína sérica (AFP)
  • gonadotrofina coriônica humana beta sérica (beta-hCG)
完整详情

治疗流程

急症处理

tumor ressecável

tumor localmente avançado

持续性治疗

tumor recorrente

撰稿人

作者

Douglas Z. Liou, MD

Clinical Associate Professor of Cardiothoracic Surgery

Division of Thoracic Surgery

Stanford University School of Medicine / Stanford Cancer Institute

Stanford

CA

利益声明

DZL declares that he has no competing interests.

Joseph B. Shrager, MD

Professor of Cardiothoracic Surgery

Chief, Division of Thoracic Surgery

Medical Director, Thoracic Oncology CCP

Stanford University School of Medicine / Stanford Cancer Institute

Stanford

CA

利益声明

JBS declares that he has no competing interests.

Nathaniel J. Myall, MD

Clinical Assistant Professor of Medical Oncology

Stanford University School of Medicine / Stanford Cancer Institute

Stanford

CA

利益声明

NJM has received research funding from Genentech.

Kavitha Ramchandran, MD

Professor of Medical Oncology

Stanford University School of Medicine / Stanford Cancer Institute

Stanford

CA

利益声明

KR has been compensated for consulting services by Varian Medical Systems and Curio Bioscience. She has served on the advisory council for Group Well and Pathomiq and has received honorarium from the Binaytara Foundation for speaking at a conference.

Lucas Kas Vitzthum, MD

Clinical Assistant Professor of Radiation Oncology

Department of Radiation Oncology

Stanford University School of Medicine

Stanford

CA

利益声明

LKV declares that he has no competing interests.

鸣谢

Dr Douglas Z. Liou, Dr Joseph B. Shrager, Dr Nathaniel J. Myall, Dr Kavitha Ramchandran, and Dr Lucas Kas Vitzthum would like to gratefully acknowledge Dr Tracey Evans, Dr Nicholas Choong, Dr Mario Gasparri, and Dr Cameron Wright, previous contributors to this topic.

利益声明

TE has received consultancy fees from Genentech and Celgene. She is a board member of Wissahickon Hospice. Educational events include an annual thoracic educational series sponsored by Imedex. NC and MG declare that they have no competing interests. CW is an author of a number of references cited in this topic.

同行评议者

Enrico Ruffini, MD

Associate Professor

Thoracic Surgery

University of Torino

Torino

Italy

利益声明

ER is an author of a reference cited in this topic.

James R. Jett, MD

Emeritus Professor of Medicine

National Jewish Health

Denver

CO

利益声明

JRJ is co-editor of the section on thymoma in Up To Date. He is also co-chief medical officer for Biodesix Inc.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Girard N, Ruffini E, Marx A, et al. Thymic epithelial tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(suppl 5):v40-v55.全文  摘要

Phan AT, Öberg K, Choi J, et al. NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the thorax (includes lung and thymus). Pancreas. 2010;39:784-98.全文  摘要

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: thymomas and thymic carcinomas [internet publication].全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Tumor tímico images

  • 鉴别诊断

    • Linfoma
    • Tumor mediastinal maligno de células germinativas: seminoma
    • Tumor mediastinal de células germinativas: não seminoma
    更多 鉴别诊断

  • 指南

    • NCCN clinical practice guidelines in oncology: thymomas and thymic carcinomas
    • The Society of Thoracic Surgeons expert consensus document on the surgical management of thymomas
    更多 指南
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