Thymoma and thymic carcinoma are the representative tumors arising from the thymic epithelium. Thymoma is well known for association
with autoimmune diseases including myasthenia gravis, suggesting its biological activity. Herein, recent progress in research
of thymoma is reviewed with reference to its immunological function. Myasthenia gravis is frequently associated with WHO type
B1 and B2 thymomas. These types of thymomas hold a significant number of CD4
+CD8
+ double-positive T cells, and at the same time, the neoplastic epithelial cells express HLA-DR molecules at a slightly reduced
level compared with the normal thymus. The impaired expression of HLA-DR molecules in neoplastic epithelial cells of thymomas
possibly affects positive selection of CD4
+CD8
− single-positive T cells and may result in alteration of its repertoire. The function of thymoma neoplastic cells as the cortical
epithelium of the thymus and the morphological resemblance of thymomas to the cortex suggest that thymoma is of cortical epithelial
origin; this might imply that thymoma lacks the functional medulla where professional antigenpresenting cells are engaged
in negative selection. These findings suggest that thymoma generates autoreactive T cells causing autoimmunity. Further investigation
on immunological function of thymoma is supposed to elucidate the pathogenesis of thymoma-related autoimmunity and the high
affinity of thymoma with myasthenia gravis. In addition, studying the biology of thymoma is also expected to contribute to
further understanding of T-cell development and immunological tolerance in the human, because thymoma can be considered an
acquired thymus.
Key words Thymoma - Thymic carcinoma - T-cell development - Human leukocyte antigen - Paraneoplastic autoimmunity
This review was submitted at the invitation of the editorial committee.