 Good morning. I am Dr. Arun Kunchere-Joseph. I'm a PG resident at Pushfiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala. And today for my oral presentation, I'll be talking about cross-sectional imaging of spectrum of thymid myoplasms, a pictorial essay. So the thymus, as the Greeks believe, to be the location of our soul, hence the name, is actually a lymphatic organ crucial in the development and maturation of immune system during childhood. It involutes with advancing age. However, radiological identification of myoplasms of the thymus is significant for effective diagnosis, staging and to decide on further cause of management of the disease. A novel classification scheme by the World Health Organization divided the thymid myoplasms into types A, AB, B1, B2, B3 and C, based on the histopathological correlation. Of these, types A, AB and B1 were the low-risk category and B2, B3 and C belong to the high-risk category. The aim of my study was to discuss the spectrum of thymid myoplasms with radiologic pathological correlation and to illustrate a wide range of myoplastic conditions affecting the thymus with the help of a pictorial essay. And the methods used included reviewing the CT images of a number of patients in the recent past who were diagnosed with thymid myoplasms based on imaging findings. The imaging diagnosis was then compared with the pathological reports and detailed pictorial essay of the imaging manifestations of spectrum of thymid myoplasms illustrated. So coming to the discussion, I'll be discussing a few of the cases that came out from a number of cases that came to my department and the interesting ones to discuss the spectrum of thymid myoplasms. My first case was actually a 72-year-old female who presented to the pulmonary OPD with three episodes of haemoplysis and was advised to CT chest. So imaging showed a plain image, axial section, showed a well-defined, soft tissue density lesion involving the anterior medistinum with no evidence of loss of fat planes with the adjacent vasculature. There was no evidence of any significant medistinal lymph nodes, post-contrast image revealed enhancement with the centripetal filling, and there was no evidence of any bone erosion. So this turned out to be a Taipei thymoma. My next case was actually a 57-year-old female who presented with cuff for the past three weeks. Test X-ray revealed a left hyla mass. This is the plain coronal reformatted image showing a lobulated, well-defined lesion with a tiny speck of calcification involving the anterior medistinum moved towards the left side with heterogeneous post-contrast enhancement. However, it is imperative that we note there is no evidence of any vascular invasion or infiltration and there was no evidence of any bone erosions. Again, this turned out to be a Taipei thymoma. My third case was also a Taipei thymoma. It was a 69-year-old male with carcinoma rectum and the anterior medistinal lesion was identified incidentally. This was a solid cystic lesion with predominant solid component. There was no evidence of any calcifications. This is compressing the left tracheocryphalic vein and also, to some extent, the superior vena cava. However, there was no evidence of any vascular invasion. Even though it was abutting the mangrove sternum, there was no evidence of any erosion or lysis of the bone as such. There was no evidence of any necks. And again, Taipei thymoma. Case four was actually an 80-year-old lady who presented with breathlessness and cuff for one week duration. And the CT image revealed an irregularly marginated, heterogeneously enhancing solid cystic lesion with predominant solid component showing heterogeneous post-contrast enhancement with erosion of adjacent bones, especially the rib and the left half of mangrove sternum and also vascular infiltration. Bilateral pleural effusion was also noted. The coronal as well as the sagittal images revealed chunky calcifications within the lesion and vascular infiltration as such. This turned out to be a type B3 thymoma. My fifth case was a 44-year-old lady who is a known case of mycenae gravis. And as you all know, mycenae gravis has great correlation with the thymoma. And our plain CT revealed a well-defined, mildly-lobulated, soft tissue density lesion involving the anterior medial sternum. It was small in size, most towards the left side. And near homogenous enhancement was noted in the post-contrast images with no evidence of infiltration of the adjacent vasculature, no evidence of bone erosions. And this turned out to be a small thymoma. My sixth case was a 66-year-old gentleman with history of weight loss and chest discomfort for the past three months. And his image revealed an irregularly-marginated soft tissue density lesion involving the anterior medial sternum with extension into the lung panorama as well on the left side with tiny specs of calcification and post-contrast images revealing heterogeneous post-contrast enhancement, infiltration of the adjacent vessels, the arteries and the veins, pleural effusion on the left side with pleural thickening and enhancement, and mild erosion of the bones as well. Again, the coronal as well as the sagittal reformatted images are showing the heterogeneous enhancement, the infiltration of the vessels as well as the pleural effusion. This turned out to be a small cell carcinoma thymus, which is type C, the other end of the spectrum of thymic neoplasms. My seventh case was an interesting one. It was a 72-year-old male who was known case of COPD, presenting with complaints of cuff and breathing difficulty. He also had a history of loss of weight and appetite. And his images revealed fairly well-defined, mildly-lobulated, heterogeneously-enhancing lesion involving the anterior medial sternum, abutting the aorta, and we gave the possibility of a thymic neoplasm. However, a differential of an necrotic lymph nodal mass conglomerate was also given. And surprisingly, the HPR came out to be tuberculosis. My eighth case was a 67-year-old gentleman who presented with heaviness of chest and multiple swellings in the axilla. CT revealed, near-homogenously enhancing lesions involving the medial sternum with medial sternal lymph nodes as well, which were seen to compress the SVC as well as the brachycephalic vein with no evidence of infiltration of the same. There was no evidence of any calcification within the lesion, no evidence of any necrosis, and no erosions of the bones at all. And this turned out to be a diffused large B-cell lymphoma. So, from the images that I've studied or the cases that I've shown, it is very clear that the findings more common in high-risk thymomas and thymic carcinomas include a lobulated contour, medistinal fat invasion, and great vessel invasion in most cases, except for maybe a one case where a tiny speck of calcification was seen in a type A thymoma. Type A thymomas are more well-defined, well-encapsulated with no evidence of any calcifications, no evidence of vessel infiltration or bony erosions. B type thymomas showed more calcifications. So, overall, I think we were able to identify the types of thymomas from the radiological imaging itself, and they were quite correlated with the histopathological report as such. We also consider the close differentials of lymphoma, as well as tuberculosis while reporting a thymic neoplasm. So, the study proved that imaging studies are an imperative part in accurately diagnosing the various thymic neoplasms, and that imaging studies correlate with the histopathological report. I thank CTBus from the bottom of my heart for giving me this opportunity to present my paper. Thank you.