The 2015 world health organization classification of tumors of the thymus continuity and changes

Alexander Marx*, John K.C. Chan, Jean Michel Coindre, Frank Detterbeck, Nicolas Girard, Nancy L. Harris, Elaine S. Jaffe, Michael O. Kurrer, Edith M. Marom, Andre L. Moreira, Kiyoshi Mukai, Attilio Orazi, Philipp Ströbel

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


This overview of the 4th edition of the World Health Organization (WHO) Classification of thymic tumors has two aims. First, to comprehensively list the established and new tumor entities and variants that are described in the new WHO Classification of thymic epithelial tumors, germ cell tumors, lymphomas, dendritic cell and myeloid neoplasms, and soft-tissue tumors of the thymus and mediastinum; second, to highlight major differences in the new WHO Classification that result from the progress that has been made since the 3rd edition in 2004 at immunohistochemical, genetic and conceptual levels. Refined diagnostic criteria for type A, AB, B1-B3 thymomas and thymic squamous cell carcinoma are given, and it is hoped that these criteria will improve the reproducibility of the classification and its clinical relevance. The clinical perspective of the classification has been strengthened by involving experts from radiology, thoracic surgery, and oncology; by incorporating state-of-theart positron emission tomography/computed tomography images; and by depicting prototypic cytological specimens. This makes the thymus section of the new WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart a valuable tool for pathologists, cytologists, and clinicians alike. The impact of the new WHO Classification on therapeutic decisions is exemplified in this overview for thymic epithelial tumors and mediastinal lymphomas, and future perspectives and challenges are discussed.

Original languageEnglish
Pages (from-to)1383-1395
Number of pages13
JournalJournal of Thoracic Oncology
Issue number10
StatePublished - 1 Oct 2015
Externally publishedYes


FundersFunder number
National Cancer InstituteZIABC011070


    • Adenocarcinoma
    • Atypical type A thymoma
    • Carcinoid
    • Classification
    • Combined large-cell neuroendocrine carcinoma
    • Combined thymic carcinoma
    • Computed tomography
    • Cytology
    • Dendritic cell tumor
    • Ectopic tumor
    • GTF2I
    • Genetic
    • Germ cell tumor
    • Grey zone lymphoma
    • Histology
    • Hodgkin lymphoma
    • Immunohistochemistry
    • Immunohistology
    • International Thymic Malignancy Interest Group
    • Lymphoma
    • Mediastinal
    • Mediastinum
    • Metastasis
    • NUT carcinoma
    • Neuroblastoma
    • Neuroendocrine
    • Pathology
    • Positron emission tomography
    • Primary mediastinal large B-cell lymphoma
    • Sarcoma
    • Staging
    • Thymic carcinoma
    • Thymoma
    • Thymus
    • World Health Organization


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