Immunoglobulin G4 Thymic Tumor

Arafat, Amr A.; Torky, Mohammad A.; Elhamshary, Mustafa; Aboelnasr, Mohamed Sabry

doi:10.1016/j.athoracsur.2019.02.043

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…Here, the patient had a medical history of an IgG4-related disorder that was partially treated with immunosuppressive steroid therapy. IgG4-related disorders in the thymus have been reported in the literature, [6][7][8][9] and in some cases, it has been demonstrated to present as an anterior mediastinal mass 8,9 ; however, to the best of our knowledge, no reports are available on thymic hyperplasia with lymphoepithelial sialadenitis-like features that are associated with IgG4-related disorders.…”

Section: Discussionmentioning

confidence: 99%

Thymic Hyperplasia With Lymphoepithelial Sialadenitis-Like Features Arising in a Patient With Immunoglobulin G4-Related Disorders: A Case Report

et al. 2023

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Thymic hyperplasia with lymphoepithelial sialadenitis-like features is characterized by thymic hyperplasia with lymphocytic infiltrates in the thymic epithelium. The lesion differs from other forms of thymic hyperplasia, including true and follicular thymic hyperplasia, in that it presents at an advanced age and has been reported to be unassociated with autoimmune diseases. We report a case of thymic hyperplasia with lymphoepithelial sialadenitis-like features in a 55-year-old male patient with a history of an immunoglobulin G4 (IgG4)-related disorder. Histologically, the resected mediastinal mass showed features consistent with those of thymic hyperplasia with lymphoepithelial sialadenitis-like features. In addition, the IgG4/IgG ratio was elevated in the polyclonal plasmacytoid infiltration. Thymic hyperplasia with lymphoepithelial sialadenitis-like features has not been reported to be associated with IgG4-related disorders; however, as shown in our report, it is crucial to include it in the differential diagnosis of a mediastinal mass in a patient with IgG4-related disorders.

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Section: Discussionmentioning

confidence: 99%

Thymic Hyperplasia With Lymphoepithelial Sialadenitis-Like Features Arising in a Patient With Immunoglobulin G4-Related Disorders: A Case Report

et al. 2023

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“…Several inflammatory lesions mimicking malignant lesions have been found in the mediastinum. [47] A thoracoscopic biopsy is a preferred approach for benign mediastinal lesions in infants; however, more experience and longer follow-up are required before promoting this approach with malignant tumors.…”

Section: Mediastinal Tumors and Cystsmentioning

confidence: 99%

Thoracoscopy in pediatrics: Surgical perspectives

Bawazir

2019

Ann Thorac Med

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Thoracoscopic surgery and other minimally invasive approaches in children achieved marked advancement and expanded to include several disciplines in the last decade. The new armamentarium of the minimally invasive surgery including the smaller instruments and better magnification led to the application of this technology in the small infants and neonates. Currently, thoracoscopy is considered the preferred surgical approach for various conditions in neonates and infants over the standard thoracotomy, and thoracoscopic training is included in the surgical training curriculum for the residents in many institutes worldwide. Children are different from adults, and technique modifications are required when using thoracoscopy in children. Thoracoscopy showed satisfactory results in several operations including pulmonary resections, mediastinal tumors biopsies or resections, repair of the diaphragmatic hernias, decortication, and tracheoesophageal fistula. This review aims to address the unique aspects of thoracoscopic surgery in children, identify its potential technical and anatomical challenges, and the proposed solutions. A literature search for latest and relevant publications was done using the keywords (thoracoscopy; pediatric; lung biopsy; decortication; lobectomy; mediastinum; esophagus; and diaphragmatic hernia).

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“…Generally, vasculitis is classified according to the vessels and organs affected into large, medium, small, and variable vessels vasculitis, single organ vasculitis, vasculitis associated with systemic autoimmune disease [4], and vasculitis associated with probable etiology [5]. Despite being the largest artery, the aorta can be affected by all types of vasculitis.…”

Section: Classification Of Autoimmune Aortitismentioning

confidence: 99%

Surgery for autoimmune aortitis: unanswered questions

Arafat

2019

Cardiothorac Surg

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Background: The aorta is rarely affected by autoimmune vasculitis, which can lead to aortic dilatation requiring surgery. Autoimmune aortitis may affect one aortic segment or the entire aorta, and in some cases, the aorta may be affected at different time intervals. Because of the rarity of the disease and the limited cases described in the literature, management of autoimmune aortitis is still controversial. We aimed to review the current literature evidence regarding these controversial aspects for the management of autoimmune aortitis and give recommendations based on this evidence. Main text: Immunosuppressants are generally indicated in vasculitis to halt the progression of the disease; however, its role after the occurrence of aortic dilatation is debatable since further aortic dilatation would eventually occur because of the weakness of the arterial wall. In patients with a localized ascending aortic dilatation who required surgery, the optimal approach for the distal aorta is not known. If the probability of disease progression is high, it is not known whether the patients would benefit from postoperative immunosuppressants or further distal aortic intervention may be required. The risk of rupture of the weakened aortic wall was not established, and it is debatable at which diameter should these patients have surgery. In patients with previous ascending surgery for autoimmune aortitis, the endovascular management of the distal aortic disease has not been studied. The inflammatory process may extend to affect the aortic valve or the coronary vessels, which may require special attention during the procedure. Conclusion: Patients with diagnosed autoimmune aortitis are prone to the development of the distal aortic disease, and endovascular intervention is feasible in those patients. Patients with concomitant aortic valve can be managed with the aortic valve-sparing procedure, and preoperative screening for coronary disease is recommended. Immunosuppressants should be used early before aortic dilatation, and its role postoperatively is controversial.

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Immunoglobulin G4 Thymic Tumor

Cited by 3 publications

References 8 publications

Thymic Hyperplasia With Lymphoepithelial Sialadenitis-Like Features Arising in a Patient With Immunoglobulin G4-Related Disorders: A Case Report

Thymic Hyperplasia With Lymphoepithelial Sialadenitis-Like Features Arising in a Patient With Immunoglobulin G4-Related Disorders: A Case Report

Thoracoscopy in pediatrics: Surgical perspectives

Surgery for autoimmune aortitis: unanswered questions

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