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The Mediastinum—Pandora’s Box

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 1 July 2026 | Viewed by 1121

Special Issue Editor

Special Issue Information

Dear Colleagues,

The mediastinum is often called Pandora’s box due to the wide spectrum of lesions that may arise within the mediastinal compartment. The pathology within this compartment is rich not only in tumors but also in benign, inflammatory, and infectious lesions. Even though this pathology is rich, clinical diagnosis and diagnostic imaging play a highly important role in unraveling the nature of the pathology. In this Special Issue of Cancers, the goal is not to limit the Special Issue to specific conditions but rather to highlight the diversity that makes the mediastinum a very important and special anatomical area. Therefore, authors are encouraged to provide their experience in medical conditions that affect the mediastinum [thymus], diagnostic imaging that plays a highly important role in assessing the pathology that may be present, diagnostic surgical pathology that plays a decisive role in determining the nature of the pathology, and finally the treatment and follow up that may be seen in patients afflicted by pathology of the mediastinum. In addition, one element that is often important to highlight is the demographic and epidemiological aspects of the diverse pathology that may arise in the mediastinum. Thus, this Special Issue is inclusive of the richness of the mediastinum.

Prof. Dr. Cesar A. Moran
Guest Editor

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Keywords

  • mediastinum
  • thymus
  • imaging
  • surgery
  • thymoma
  • germ cell tumors

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Published Papers (1 paper)

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Review

15 pages, 8492 KB  
Review
Thymic Hyperplasias in Practice: Clinical Context, Histological Clues, and Management Implications
by Stefan Porubsky
Cancers 2026, 18(1), 84; https://doi.org/10.3390/cancers18010084 - 27 Dec 2025
Viewed by 470
Abstract
Background and Objective: Thymic hyperplasias constitute a heterogeneous group of primarily non-neoplastic conditions characterized by either enlargement of the thymic parenchyma or the proliferation of lymphoid follicles. Differentiating these entities is crucial, as they exhibit significant differences in their epidemiology, clinical associations, and [...] Read more.
Background and Objective: Thymic hyperplasias constitute a heterogeneous group of primarily non-neoplastic conditions characterized by either enlargement of the thymic parenchyma or the proliferation of lymphoid follicles. Differentiating these entities is crucial, as they exhibit significant differences in their epidemiology, clinical associations, and implications for patient management. This review aims to synthesize the current knowledge on true thymic hyperplasia, rebound thymic hyperplasia, thymic follicular hyperplasia, and thymic hyperplasia with lymphoepithelial sialadenitis-like features, and to delineate their diagnostic boundaries in histology. Methods: A systematic literature review of the Medline database was conducted, encompassing all publications available up to November 2025. The search terms included thymic hyperplasia, true thymic hyperplasia, rebound thymic hyperplasia, thymic follicular hyperplasia, and lymphoepithelial-sialadenitis-like thymic hyperplasia. Studies concerning the histopathological, radiological, and clinical presentations as well as reference works concerning age-related thymus size and weight were included. Limitations stem from the scarcity of systematic investigations and heterogeneity of the available studies. Results: Thymic hyperplasia encompasses biologically diverse entities unified solely by their benign nature, yet distinguished by distinct histological patterns and clinical scenarios. True thymic hyperplasia and rebound hyperplasia preserve the organ’s fundamental architecture and lack association with autoimmunity; however, they differ in age distribution and clinical context. Thymic follicular hyperplasia reflects an immune-mediated process, strongly linked to early-onset myasthenia gravis, and is characterized by germinal-center formation within thymic lobes. Lymphoepithelial-sialadenitis-like thymic hyperplasia, by contrast, represents an epithelial–lymphoid proliferation with pronounced architectural distortion, frequent cystic changes, and notable associations with systemic non-myasthenic autoimmune diseases as well as thymic mucosa-associated-lymphatic-tissue lymphoma. Conclusions: Overall, clinical history, serological data, imaging, and detailed histopathology remain indispensable for differentiating thymic hyperplasias, some of which necessitate further systemic evaluation due to their association with autoimmune diseases or lymphomas. Full article
(This article belongs to the Special Issue The Mediastinum—Pandora’s Box)
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