{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:41:56Z","timestamp":1758818516747,"version":"3.37.3"},"reference-count":15,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Even though it is a rare subtype, identifying the genetic features of thymic adenocarcinoma is valuable for a multifaceted understanding of thymic epithelial tumors. We experienced a female patient with thymic adenocarcinoma associated with thymic cysts. The tumor consisted of a solid whitish lesion (lesion\u20101) and a large cystic lesion with small papillary nodules (lesion\u20102). Microscopically, lesion\u20101 exhibited poorly differentiated adenocarcinoma accompanying numerous inflammatory cell infiltrates, and lesion\u20102 (the nodules within the cystic lesion) exhibited enteric\u2010type adenocarcinoma. Consistent with the histological difference, whole\u2010exome sequencing revealed that these two components exhibited distinct genetic features, except for only a few shared mutations, including <jats:italic>CDKN2A<\/jats:italic> truncation. Lesion\u20101 exhibited microsatellite instability\u2010high signature with high mutation burden, for which immune checkpoint inhibitors might apply; and lesion\u20102 exhibited whole\u2010genome doubling with <jats:italic>KRAS<\/jats:italic> hotspot mutation. Our case presents novel genetic features of thymic adenocarcinoma and demonstrates that distinct mutational processes can be operative within a single tumor.<\/jats:p>","DOI":"10.1111\/pin.13171","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T21:52:45Z","timestamp":1632865965000},"page":"849-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A primary thymic adenocarcinoma with two components that traced distinct evolutionary trajectories"],"prefix":"10.1111","volume":"71","author":[{"given":"Ayami","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Diagnostic Pathology Kyoto University Hospital Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-2706","authenticated-orcid":false,"given":"Yosuke","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Diagnostic 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