{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T04:04:44Z","timestamp":1775275484001,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K19546"],"award-info":[{"award-number":["23K19546"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ectopic germinal centers (GCs) are often formed in the thymus of patients with anti\u2010acetylcholine receptor antibody (anti\u2010AChR Ab)\u2010positive thymic epithelial tumors (TETs) and are considered sites where B cells undergo affinity maturation to produce high\u2010affinity anti\u2010AChR Abs, contributing to the development of myasthenia gravis. To evaluate the clinical relevance of these ectopic GCs, we analyzed their distribution and associations with thymic involution and anti\u2010AChR Ab titers using paraffin\u2010embedded surgical specimens from 79 TET patients. Thymic involution was scored, and immunohistochemistry was performed to identify cells involved in GC formation. GCs were identified in 32 of the 79 cases. The anti\u2010AChR Ab+ group had significantly higher frequencies of GCs in the residual thymus compared to the Ab\u2212 group. In all cases with GCs in the residual thymus, GCs were found both near the tumor and at distances greater than 1\u2009cm from the tumor. Within the anti\u2010AChR Ab+ group, GC+ patients were significantly younger and showed milder thymic involution than GC\u2212 patients. The number of GCs per unit area positively correlated with serum antibody titer. In Ab+ cases, AChR\u2010\u03b11 antigens were significantly more frequent in GC+ cases. In mildly involuted thymus, AChR antigens, antigen\u2010presenting cells, and B cells were detected in the medulla, whereas these were rarely observed in severely involuted thymus. These findings suggest that GC formation occurs preferentially in a less involuted thymus and that surgical resection of at least the extent of a total thymectomy may be indicated in younger patients with anti\u2010AChR Ab+ TETs.<\/jats:p>","DOI":"10.1111\/cas.70183","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:40:34Z","timestamp":1756744834000},"page":"3209-3219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Distribution of Ectopic Germinal Centers in Thymic Epithelial Tumors and Their Relationship With Thymic Involution"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6641-0078","authenticated-orcid":false,"given":"Tatsuo","family":"Furuya","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery Kyoto Prefectural University of Medicine, Graduate School of Medical Science  Kyoto 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