A spindle cell varient of thymic carcinoid tumor. A clinical, histologic, and fine structural study with emphasis on its distinction from spindle cell thymoma.

We describe the clinical, histologic, and fine structural features of two thymic carcinoid tumors that had a major spindle cell component, and present the reason for classifying our two cases as variants of thymic carcinoid tumors. These tumors pursued an aggressive clinical course, demonstrated histologic features such as vascular invasion and mitotic activity, ultrastructurally contained numerous dense-core granules, and lacked prominent tonofilaments and well-formed desmosomes. Radiotherapy, even for apparently encapsulated cases, may be indicated for this aggressive mediastinal neoplasm, which can be clearly separated from the thymoma by clinical, histologic, and fine structural criteria.