Can thymic involution be misdiagnosed as thymoma on CT?

Thymic involution is generally not misdiagnosed as thymoma on CT imaging.

The thymus is located in the upper anterior mediastinum, behind the manubrium sterni. It varies in shape and consists of asymmetric left and right lobes. It is typically larger in newborns and young children, begins to involute during puberty, and usually completes involution by 16–18 years of age. If a CT scan performed after age 18 reveals a mass in the anterior mediastinum, it may indicate incomplete thymic involution; however, this is generally not diagnosed as thymoma. Thymoma is a tumor arising in the anterior mediastinum, appearing on CT as a high-density shadow, often round or oval in shape.

To confirm a diagnosis of thymoma, additional tests such as magnetic resonance imaging (MRI) or needle biopsy may be required, followed by targeted treatment. Currently, the primary treatment method is surgical resection. For patients who are not candidates for surgery, radiotherapy, chemotherapy, or other treatments may be used.