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NORMAL HISTOLOGY

PRESENTATION
ON
THYMUS

By: Dr. Rajesh

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INTRODUCTION

Thymus is one of lymphoid organ of immune system

Immune system is anatomically and functionally complex and dynamic

Evaluation of every compartment by pathologist is important (eg.


Thymus- Cortex / medulla / cortex medulla ratio). Hence all
compartments needs to be identified and captured properly by system.

To make accurate judgements on image evaluation for not normal


changes seen in thymus, data available on gross and clinical pathology
changes add a value.

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Thymus Panoramic view @ 1x & 5x (14wk_01)

The thymus is a lobulated organ enclosed by connective tissue capsule

Trabeculae is a connective tissue, which arises from the capsule and extend into
the interior of the organ and subdivide the thymus into numerous lobules

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Image showing trabeculae dividing thymus into different lobes

Trabeculae

Trabeculae is made of connective tissue fibres

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Image showing three major components of thymus @ 5x

Capsule

Cortex

Medulla

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Thymus Capsule & Trabeculae@ 5x & 24x (14wk_01)
Capsule

14wk_05 @10x

Trabeculae

Blood vessels pass into the thymus via the connective tissue capsule and the trabeculae.
Trabeculae may show presence of blood vessels and/or adipose tissue
Green annotation = Small blood vessels ; Blue annotation = Cells of connective tissue fibres
showing nuclei, irregular in shape, variable in size.
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Thymic cortex @ 10x & 40x (14wk_01)

Cortex

@ 54x

Cortex @ 40x

Each lobule consists of dark staining outer cortex and a light staining inner medulla
Cortex of each lobule composed of densely packed lymphocytes
Lymphocytes are spherical in shape, differ in amount of cytoplasm, nuclear staining is
dense due to condensed chromatin 7
Image showing thymic medulla components @ 40x

Epithelial
reticular
cells

Thymic medulla is composed of few lymphocytes but more epithelial reticular cells
Epithelial reticular cells are bigger in size than lymphocytes, show less staining and
appears paler than lymphocytes.
The medulla also consists of numerous thymic corpuscles (Hassall's corpuscle), which is
the characteristic feature of thymus.

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Image showing thymic medulla components @ 40x

Epithelial reticular
cells

Hassalls
corpuscles

14wk_01
14wk_08
Hassalls corpuscles are oval structure consisting of round or spherical aggregations of flattened
epithelial cells
Hassalls corpuscles also exhibit calcification or degenerating centres that stain pink or eosinophilic.
Many times medulla seems to be continuous between lobules (eg. slide no. 6 or image no.14wk_13)

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THANK YOU

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List of Not Normal Findings Thymus (Reference: goRENI)

1 Atrophy

2 Epithelial cysts

3 Decreased cortico-medullary ratio

4 Depletion, lymphoid

5 Fibrosis

6 Increased cellularity of compartments

7 Increased cortico-medullary ratio

8 Inflammation

9 Involution, physiological

10 Mineralization

11 Necrosis, lymphoid

12 Parathyroid, ectopic

13 Pigmentation

14 Thymus, ectopic

15 Thyroid, ectopic

Proliferative Lesions

1 Hyperplasia, epithelial tubules and cords

2 Hyperplasia, lobular

3 Hyperplasia, lymphoid 11
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