Associated Immunological Disorders and Cellular Immune Dysfunction in Thymoma: A Study of 87 Cases from Thailand

Abstract

Several immune disorders are often associated with thymoma. The aim of this study was to analyze the correlation between clinicopathological features of Thai patients with thymoma and concomitant immune-mediated diseases. Medical records of 87 patients diagnosed with thymoma during a 10-year period were retrospectively reviewed. Peripheral blood T cell subsets along with cytokine responses in 15 thymoma patients and 15 healthy controls were comparatively analyzed. The results demonstrated that thymoma type AB and B2 were the most common types among patients diagnosed with thymoma. The most common presentation was incidentaloma, followed by local chest symptoms and autoimmune diseases. The prevalence of autoimmune diseases, immunodeficiency states, and secondary neoplasms was 34.5, 10.3, and 10.3 %, respectively. Autoimmune diseases were most frequently found in thymoma type B2 and sometimes associated with clinical immunodeficiency, although classic Good's syndrome was rare. Patients with thymoma had significantly lower percentage CD4(+ve) T cells and interferon γ response, but higher percentage regulatory T cells than those in healthy controls. This study indicated that the aberrant immunologic disorders comprising autoimmune diseases, immunodeficiency states, and secondary neoplasms were found in almost 40 % of Thai patients with thymoma and possibly related to defectiva cytokine responses and altered T cell subsets.

Mutation in West Nile Virus Structural Protein prM during Human Infection

“…Although patients with thymoma B2 may, in rare cases, exhibit hypogammaglobulinemia and cellular immune dysfunction ( 11 ), this patient was considered immunocompetent because his medical history and follow-up after this infection did not show any indication of immune deficiency. The change in neutrophil count during acute infection is intriguing because neutrophils have been shown to serve as a reservoir for WNV replication during early infection and to contribute to viral clearance at a later stage of illness ( 12 ).…”

Artritis reumatoide como forma de presentación de un timoma

“…Se han publicado múltiples fenómenos autoinmunes en relación con timoma, fundamentalmente en relación con miastenia gravis, pero también polimiositis, lupus, artritis reumatoide, tiroiditis, Sjogren, hepatitis autoinmune, enfermedad celiaca, pén go…y en ocasiones solapándose unas a otras 3 dejando entrever por tanto una relación inmunopatológica La diferenciación histopatológica (clasi cación Who) parece tener relación con la asociación a autoinmunidad siendo el fenotipo B2 el más frecuentemente asociado 2 . La asociación con artritis reumatoide es poco frecuente con tan solo 3 casos descritos en literatura, uno asociado a tiroiditis de Hashimoto 4 y dos de ellos asociados a la toma de fármacos inmunosupresores y aparición de timoma en dicho contexto 5,6 .…”

Alteration in gene expression profile of thymomas with or without myasthenia gravis linked with the nuclear factor‐kappaB/autoimmune regulator pathway to myasthenia gravis pathogenesis

“…Thymoma is a mediastinal tumor originating from the thymus epithelial cells and accounting for approximately 25% of mediastinal tumors . Approximately 30% of patients with thymoma also have myasthenia gravis (MG) . Recently, studies have suggested that thymoma with autoimmune disorders is likely mediated by the dysfunction in central tolerance and immunoregulation .…”

“…1 Approximately 30% of patients with thymoma also have myasthenia gravis (MG). 2 Recently, studies have suggested that thymoma with autoimmune disorders is likely mediated by the dysfunction in central tolerance and immunoregulation. 3 However, the precise mechanisms underlying the process of thymoma-related disorders have not been clarified.…”