Thymoma: Update for the New Millenium

Johnson, Scott; Eng, Tony Y.; Giaccone, Giuseppe; Thomas, Charles R.

doi:10.1634/theoncologist.6-3-239

Cited by 76 publications

(68 citation statements)

References 61 publications

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“…In fact, MHC II is reduced in patients suffering from thymoma, especially in WHO-type A and AB, which was the case in our patient with a histological WHO-type AB thymoma [12]. This gives us an immunological explanation for the severe nematode infection we saw in our patient.…”

Section: Discussionsupporting

confidence: 71%

Strongyloides Hyperinfection in a Patient with Thymoma - A Rare Presentation of the Good Syndrome

Migaud¹,

Beushausen²,

Pankow³

et al. 2017

J Clin Case Rep

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We present a case of Strongyloides stercoralis hyperinfection syndrome in the frame of a Good syndrome. The Good Syndrome is a rare cause of combined B-and T-cell immunodeficiency that occurs in association with a thymoma. Patients affected with Good syndrome have increased susceptibility to infections.Keywords: Strongyloides stercoralis; Strongyloides hyperinfection syndrome; Good syndrome; Thymoma Case ReportWe present the case of a 53-year old male from the Democratic Republic of Congo (DRC) who presented himself to his general practitioner with a long-lasting infection of the upper airways that did not respond to antibiotic therapy. A chest X-ray was performed and the patient was hospitalized because of a mediastinal mass. After CT-scan and a biopsy the diagnosis of a Thymoma Type AB Masaoka Stadium II was established. The surgical in toto thymectomy was performed without complications. A few days postinterventionally the patient presented with serious alteration of his general condition, constipation, vomiting after food intake and weight loss to now 35 kg, representing a BMI of 13.7 kg/m 2 . Symptomatic therapy was initiated and the patient was discharged. The patient was seen again by the thoracic surgeons for a follow up and removal of the surgical sutures. Because of a further alteration of his general condition and persistent gastrointestinal symptoms the patient was admitted to our clinic.We performed a CT-scan of thorax and abdomen, diagnosing a nosocomial pneumonia consistent with low grade fever and a cough. We initiated calculated antibiotic therapy. Laboratory results revealed elevated CRP, normal leucocytes, no eosinophilia and most interestingly an immunodeficiency both linked to a low T-cell and B-cell count. A HIV-test showed negative (Table 1). Due to the persistence of the gastrointestinal symptoms we performed a gastroscopy. Histologically we were able to show larvae of nematodes-suspected to be Strongyloides stercoralis.Further laboratory examinations showed negative HTLV-1 antibodies and a hypogammaglobulinemia of 2.88 g/l (normal range 7-16 g/l). An IgG antibody test for Strongyloides stercoralis came back negative.In multiple stool examinations, we were able to find eggs of nematodes -suspected to be of hookworms or Strongyloides.A three-day course of ivermectin was initiated. After the second dose the vomiting stopped and the constipation became better. We performed a second course of ivermectin and additionally mebendazole because we suspected a co-infection with hookworms.Moreover, we decided to start Vancomycin because we isolated enterococcus faecalis in blood cultures and on the tip of a central venous catheter, we had to place to feed the patient parenterally.After 24 days the patient was discharged in stable and asymptomatic conditions. By the time of a follow-up visit two weeks later the patient's weight had registered little improvement, with a cachectic 41 kg BMI 16 kg/m² but in generally better conditions. Besides a still present hypogammaglobulinemia and b-cell def...

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Section: Discussionsupporting

confidence: 71%

Strongyloides Hyperinfection in a Patient with Thymoma - A Rare Presentation of the Good Syndrome

Migaud¹,

Beushausen²,

Pankow³

et al. 2017

J Clin Case Rep

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“…Los TM son típicamente de crecimiento lento, producen invasión local y las metástasis frecuentemente son limitadas a pleura, pericardio y diafragma. Las metástasis linfáticas y extratorácicas son infrecuentes 1,3,7,8,[11][12][13] . Las NET son más frecuentes en el género femenino y la mayoría se presentan entre los 40 y 60 años.…”

Section: Discussionunclassified

“…En nuestra serie 12 pacientes estaban asintomáti-cos al momento del diagnóstico siendo la NET un hallazgo. Los síntomas y signos son inespecíficos como: tos, dolor y disnea; además se pueden presentar síntomas y signos derivados de la compresión de estructuras como síndrome de vena cava superior y con síndromes paraneoplásicos o autoinmunes como: Miastenia Gravis (MG), Artritis Reumatoidea, Lupus Eritematoso, Tiroiditis y síndrome de Sjögren 1,3,[7][8][9][10][11][12][13] . En nuestra serie los síntomas y signos se presentaron en 42 pacientes y los más frecuentes fueron los derivados de la MG, sólo 2 casos presentaron síndromes paraneoplásicos distintos a la MG.…”

Section: Discussionunclassified

“…El Carcinoide Tímico es muy infrecuente, se considera un carcinoma neuroendocrino bien diferenciado o carcinoide atípico, está formado por células cuboideas y en su citoplasma se reconocen gránulos neurosecretorios [1][2][3][4][5][6] . Los TM y los CT en conjunto constituyen del 0,06 al 1,5 % de todos los tumores, son más frecuentes entre los 40 y 60 años, su etiología se desconoce y aproximadamente el 30% son asintomáticos al momento del diagnóstico 1,3,[7][8][9][10][11][12][13] . Existen múltiples clasificaciones o estadificaciones para las NET y su aplicación clínica aún es motivo de discusión 1,3,12,[14][15][16][17][18][19][20][21] (Anexo 1).…”

Section: Introductionunclassified

“…La cirugía es el tratamiento de elección para la mayoría de los casos y se han descrito variables asociadas a supervivencia 1,3,7,8,11,12 . Los objetivos de nuestra comunicación son describir las características, tratamiento y variables asociados a supervivencia de NET.…”

Section: Introductionunclassified

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Neoplasias epiteliales del timo: timoma y carcinoma tímico: Caracterización, tratamiento y variables asociadas a supervivencia

et al. 2012

Rev Chil Cir

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Thymic epithelial tumors. Retrospective review of 54 patientsBackground: Thymic epithelial tumors are uncommon and can be associated with myasthenia gravis. Aim: To describe variables associated with survival and treatment of thymic epithelial tumors. Material and Methods: Retrospective review of surgical databases of a respiratory diseases hospital, identifying patients operated for a thymic epithelial tumor between 2000 and 2010. Follow up lasted from 12 to 156 months and information was obtained from medical records and death certificates of the Chilean national identification service. Results: Data from 54 patients aged 52.5 ± 16.4 years (33 women) was retrieved. Forty two patients were symptomatic and 47 were subjected to resective surgery. The pathological diagnosis was thymoma in 46 cases and thymic carcinoma in eight. Fourteen patients had postoperative complications and one died. Mean survival time was 101.8 ± 10.2 months. One, three and five years survival was 90.7 ± 3.9, 81.4 ± 5.7 and 71.8 ± 8.2%, respectively. Preoperative performance status of patients, histological type of the tumor and associated myasthenia gravis were predictors of survival. Conclusions: More commonly, thymic epithelial tumors appear in women, their histological type corresponds to thymomas and their resection is feasible

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Mediastinum thymoma diagnosed by FNA and thinprep technique: A case report

et al. 2005

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Thymoma is a primary tumor of the thymus epithelial cells. It may be asymptomatic or accompanied with atypical clinical symptoms or paraneoplastic syndromes, such as myasthenia gravis. The biological behavior of thymomas is unpredictable. The invasion of the capsule or the adjacent tissues is the major diagnostic criterion for the malignant behavior of these tumors. This is an interesting case of thymoma diagnosed by fine-needle aspiration biopsy (FNA) and ThinPrep technique, in a 54-year-old female patient with a history of gastric adenocarcinoma. Cytology of the mediastinum mass revealed a mixed population of epithelial cells and lymphocytes. The tumor was excised and the histopathological examination supported the cytological diagnosis. Thymomas commonly constitute a problem in differential diagnosis of mediastinum masses. FNA biopsy in correlation with ThinPrep technique and immunocytochemistry may play a significant role in clarifying the nature of these lesions and may contribute to the early management and choice of the optimal therapeutic manipulation.

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Thymoma: Update for the New Millenium

Cited by 76 publications

References 61 publications

Strongyloides Hyperinfection in a Patient with Thymoma - A Rare Presentation of the Good Syndrome

Strongyloides Hyperinfection in a Patient with Thymoma - A Rare Presentation of the Good Syndrome

Neoplasias epiteliales del timo: timoma y carcinoma tímico: Caracterización, tratamiento y variables asociadas a supervivencia

Mediastinum thymoma diagnosed by FNA and thinprep technique: A case report

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