AB020. Syndrome coronavirus type 2 (SARS-CoV-2) infection in patient with thymoma: presentation of two cases
Abstract

AB020. Syndrome coronavirus type 2 (SARS-CoV-2) infection in patient with thymoma: presentation of two cases

Antonello Cardoni1, Mirella Marino2, Arianna Di Napoli3

1Pathology Unit, Department of Clinical and Experimental Medicine, AOS Sant’Andrea, Sapienza University, Rome, Italy; 2Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy; 3Pathology Unit, Department of Clinical and Experimental Medicine, AOS Sant’Andrea, Sapienza University, Rome, Italy

Correspondence to: Mirella Marino. Department of Pathology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy. Email: mirellamarino@inwind.it.

Abstract: Patients with thymoma are more susceptible to develop infections due to possible autoimmune impairment due to autoantibodies directed towards cytokines involved in immune response, and this could play a role also in syndrome coronavirus type 2 (SARS-CoV-2) infection. We report on two cases of thymoma incidentally diagnosed in patients affected by SARS-CoV-2 infection, in one case the patient had a severe SARS-CoV-2-related pneumonia, in the second case only a mild SARS-CoV-2 infection was detected. Case No.1 was a 57 years old man with a recent history of severe SARS-CoV-2 related pneumonia, inducing treatment with corticosteroids. Imaging studies revealed the presence of an anterior mediastinal mass. Case No.2 was a 44 years old woman, with a recent history of mild SARS-CoV-2 infection treated with a domicile therapy including corticosteroids and paracetamol. Imaging studies revealed a mediastinal para-cardiac mass. In both cases the tumors were completely removed. Case No.1: after mass removal and histological examination, we made a diagnosis of B3 thymoma with a component of B2, pT3, pN0. Case No.2: after removal of the mass, the diagnosis of thymoma B2 with a minor component B3, pT1a, pNx was made. SARS-CoV-2 infection has represented the opportunity to discover the disease, because the patients were otherwise asymptomatic for the neoplasia. In both cases the patients were treated with corticosteroids. The treatment could lead to histological modifications including lymphocyte depletion, that could bring to overestimate the epithelial neoplastic component and to overdiagnoses B3 areas in an otherwise B2 thymoma. Recent studies have demonstrated that neoplastic thymic epithelial cells have significative increase of expression of cathepsin L (CTSL), one of the proteins known to be mediators and facilitators for the viral infection. Anyway, the possibility of a direct infection of the neoplastic cells by the virus has not been demonstrated and requires further studies.

Keywords: Syndrome coronavirus type 2 (SARS-CoV-2); thymoma; histotyping and cortisone

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med.2021.ab020
Cite this abstract as: Cardoni A, Marino M, Di Napoli A. AB020. Syndrome coronavirus type 2 (SARS-CoV-2) infection in patient with thymoma: presentation of two cases. Mediastinum 2021;5:AB020.

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