MyMedR

Fulltext Intrapulmonary bronchogenic cyst: single case report

How, S.H., Tee, H.P., Amran, A.R., Fauzi, A.R.M.

JUMMEC, 2008;11(2):86-88.

MyJurnal

Intrapulmonary bronchogenic cyst is a rare congenital lesion originating from abnormal budding of the embryonic foregut. It is less common than mediastinal bronchogenic cyst. We describe a case of intrapulmonary bronchogenic cyst and discuss the treatment of this condition.

Matched MeSH terms: Thymus Neoplasms

Paraneoplastic relapsing minimal change disease associated with type A thymoma in an elderly patient: A case report and literature review

Ngoh CLY, Goh GHS, Wong WK

Med J Malaysia, 2019 02;74(1):97-98.

PMID: 30846674

Thymoma is a rare mediastinal tumour that can be accompanied by different paraneoplastic syndromes. Here we report a case of Type A thymoma associated with relapsing minimal change disease (MCD). This case highlights: (1) The need to balance rapid prednisolone weaning against risk for relapse in an elderly patient at risk for steroid-induced complications. (2) The addition of calcineurin inhibitor in relapsed thymoma-related MCD, to achieve steroid sparing effects. Resection of the offending tumour and prompt immunosuppressive therapy are critical in getting best renal and overall outcomes in this rare entity.

Matched MeSH terms: Thymus Neoplasms/complications*; Thymus Neoplasms/diagnosis; Thymus Neoplasms/pathology; Thymus Neoplasms/therapy

Disseminated thymic B-cell lymphoma in a Holstein heifer

Hishamnuri WNAD, Nakagun S, Maezawa M, Sakaguchi K, Akiyama N, Watanabe KI, et al.

J Vet Diagn Invest, 2019 Nov;31(6):852-855.

PMID: 31551023 DOI: 10.1177/1040638719875501

A 19-mo-old Holstein heifer was inactive and dyspneic. Physical examination revealed wheezing, exophthalmos, a cervical mass, and lymphadenopathy. Cytology of the cervical mass and lymph nodes showed predominantly large atypical lymphocytes. Lactate dehydrogenase and thymidine kinase activities were elevated. Although nested PCR for bovine leukemia virus (BLV) using blood was positive, quantitative PCR showed a low number of provirus copies. Autopsy revealed enlargement of most lymph nodes examined, as well as white masses of various sizes in muscles of the left hindlimb and thoracic and abdominal organs. Histopathology revealed severe infiltration with neoplastic lymphocytes in these organs. The cervical mass was immune-positive for B-cell markers. The final diagnosis was thymic B-cell lymphoma with BLV infection.

Matched MeSH terms: Thymus Neoplasms/diagnosis; Thymus Neoplasms/pathology; Thymus Neoplasms/veterinary*

Fulltext A rare case of middle mediastinal thymoma mimicking left lower lobe lung tumor

Venayaga K, Ooi JSM, Shabir B

Med J Malaysia, 2005 Oct;60(4):508-10.

PMID: 16570719

Matched MeSH terms: Thymus Neoplasms/diagnosis*; Thymus Neoplasms/pathology

Fulltext Metastatic Thymic Carcinoma on Restaging 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography

Hoe Khoo AC, Ang SF

Indian J Nucl Med, 2020 10 21;35(4):364-366.

PMID: 33642772 DOI: 10.4103/ijnm.IJNM_123_20

Thymic carcinoma is a rare thymic epithelial cancer which is not only locally invasive but also highly aggressive disease. The prognosis for this cancer is poor and the surgery remains the mainstay of treatment. Thymic carcinomas have been shown to metastasize to the lymph nodes, lung, and liver. A 63-year old male who was successfully treated for thymic cancer in 2015, presented with metastatic disease recurrence to the spinal cord. We share interesting images of the spinal cord lesions as well as pituitary metastases that were incidentally detected on restaging 18F-fluorodeoxyglucose positron emission tomography-computed tomography.

Matched MeSH terms: Thymus Neoplasms

Fulltext Thymoma: a case report and review of the literature

Hamidah, A., Poulsaeman, V., Suria, A.A., Zarina, A.L., Zulfiqar, M.A., Jamal, R.

Medicine & Health, 2010;5(1):49-54.

MyJurnal

Thymomas comprise about 1% of all mediastinal tumours and are rare in children. Typically, these tumours are aggressive, with a poor outcome. The current treatment of invasive thymoma is often multidisciplinary. We report a 16-year-old boy with invasive thymoma who was successfully treated with systemic chemotherapy, surgical resection and irradiation. The patient has been in continuous remission for 6 years without radiographic evidence of tumour recurrence.

Matched MeSH terms: Thymus Neoplasms

Anaesthetic problems of space-occupying lesions of the chest

Manavalan AS

Med J Malaya, 1969 Dec;24(2):124-7.

PMID: 4244137

Matched MeSH terms: Thymus Neoplasms

An incidental finding of thymic carcinoid during urgent CABG operation

Abdullah F, Loon LG

Heart Surg Forum, 2002;5(4):E35-6.

PMID: 12538128

We present a case report of a 60-year-old Malay man who was undergoing an urgent coronary artery bypass graft (CABG) operation when a well encapsulated thymoma-like tumor was found incidentally. Total thymectomy was performed together with the CABG. Histopathological report of the tumor, however, confirmed a rare thymic carcinoid. The clinical features, management, and outcome of surgery are discussed.

Matched MeSH terms: Thymus Neoplasms/surgery*

Primary mediastinal large B-cell lymphoma and its mimickers: a rare case report with literature review

Win TT, Kamaludin Z, Husin A

Malays J Pathol, 2016 Aug;38(2):153-7.

PMID: 27568673 MyJurnal

Primary mediastinal large B-cell lymphoma (PMLBL) is an uncommon non-Hodgkin lymphoma with a distinct clinicopathological entity in the WHO classification of lymphoid malignancies. It is known to originate from B-cells of the thymus. It mimics thymic neoplasms and other lymphomas clinically and histopathologically. We reported a 33-year-old obese man who presented with shortness of breath off and on for 4 years. Radiologically, there was a huge anterior mediastinal mass. Tru-cut biopsy was initially diagnosed as type-A thymoma. Histopathological examination of the excised specimen revealed PMLBL with stromal fibrosis and sclerosis which created a diagnostic difficulty. The neoplastic cells varied from medium-sized to large pleomorphic cells, including mononuclear cells with centroblastic and immunoblastic features as well as bi-lobed Reed Sternberg (RS)-like cells and horse-shoe like hallmark cells. Some interlacing spindle cells and epithelioid cells were also present. Immunohistochemically, tumour cells expressed diffuse positivity for LCA, CD20, CD79a, CD23, Bcl2, MUM-1 and heterogenous positivity for CD30 and EMA, and were negative for CD10, CD15 and ALK. Ki67 scoring was very high. Tumour cells infiltrated into peri-thymic fat and pericardium. No malignant cells were detected in the pleural fluid and there was no bone marrow infiltration. The patient showed partial response to 6 cycles of RICE chemotherapy, and was planned for second line chemotherapy using hyper-CVAD regimen followed by autologous stem cell transplantation. This case illustrates the importance of thorough sampling and immunohistochemistry in differentiating PMLBL from its differential diagnoses.

Matched MeSH terms: Thymus Neoplasms/diagnosis

Myasthenia gravis and a rare complication of chemotherapy

Ng CV

Med J Aust, 2005 Feb 07;182(3):120.

PMID: 15698357

We describe a patient with myasthenia gravis and thymoma who developed recurrent severe myasthenic crises associated with the use of combination chemotherapy.

Matched MeSH terms: Thymus Neoplasms/complications*; Thymus Neoplasms/drug therapy*

Protection of hydroquinone-induced apoptosis by downregulation of Fau is mediated by NQO1

Siew EL, Chan KM, Williams GT, Ross D, Inayat-Hussain SH

Free Radic. Biol. Med., 2012 Oct 15;53(8):1616-24.

PMID: 22687461 DOI: 10.1016/j.freeradbiomed.2012.05.046

The Fau gene (Finkel-Biskis-Reilly murine sarcoma virus (FBR-MuSV)-associated ubiquitously expressed gene) was identified as a potential tumor suppressor gene using a forward genetics approach. Downregulation of Fau by overexpression of its reverse sequence has been shown to inhibit apoptosis induced by DNA-damaging agents. To address a potential role of Fau in benzene toxicity, we investigated the apoptotic effects of hydroquinone (HQ), a major benzene metabolite, in W7.2 mouse thymoma cells transfected with either a plasmid construct expressing the antisense sequence of Fau (rfau) or the empty vector (pcDNA3.1) as a control. HQ induced apoptosis via increased production of reactive oxygen species and DNA damage, measured using dihydroethidine (HE) staining and alkaline Comet assay, respectively, in W7.2 pcDNA3.1 cells. In contrast, when Fau was downregulated by the antisense sequence in W7.2 rfau cells, HQ treatment did not cause DNA damage and oxidative stress and these cells were markedly more resistant to HQ-induced apoptosis. Further investigation revealed that there was an upregulation of NAD(P)H: quinone oxidoreductase 1 (NQO1), a detoxification enzyme for benzene-derived quinones, in W7.2 rfau cells. Compromising cellular NQO1 by use of a specific mechanism-based inhibitor (MAC 220) and NQO1 siRNA resensitized W7.2 rfau cells to HQ-induced apoptosis. Silencing of Fau in W7.2 wild-type cells resulted in increased levels of NQO1, confirming that downregulation of Fau results in NQO1 upregulation which protects against HQ-induced apoptosis.

Matched MeSH terms: Thymus Neoplasms/drug therapy; Thymus Neoplasms/metabolism; Thymus Neoplasms/pathology*

Thymoma-associated myasthenia gravis and LGI1-encephalitis, with nephrotic syndrome post-thymectomy

Hor JY, Lim TT, Cheng MC, Chia YK, Wong CK, Lim SM, et al.

J Neuroimmunol, 2018 04 15;317:100-102.

PMID: 29395322 DOI: 10.1016/j.jneuroim.2018.01.011

Thymoma is associated with a wide spectrum of autoimmune paraneoplastic syndromes, though it is uncommon for multiple paraneoplastic syndromes to be present in a single individual. We report a rare case of an elderly gentleman who was found to have thymoma-associated myasthenia gravis and LGI1-encephalitis with myokymia, who presented with nephrotic syndrome (minimal change glomerulopathy) after thymectomy. The latter two paraneoplastic syndromes had manifested when prednisolone was tapered down to low dose. This case serves to remind neurologists that apart from paraneoplastic neurological manifestations, thymoma may also be associated with renal disease. Nephropathy in myasthenia patients with thymoma should be properly evaluated, as it is treatable with immunotherapy, and it may even occur post-thymectomy.

Matched MeSH terms: Thymus Neoplasms

Fulltext Unusual Presentation of Myasthenia Crisis Following Thymectomy and Thyroidectomy

Mohamed Daud A, Mat Baki M, Azman M, Kamaruzaman E, Mohamed AS

Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):118-120.

PMID: 31741945 DOI: 10.1007/s12070-017-1146-x

Respiratory distress after thyroidectomy and thymectomy can be challenging. We encountered a 70-year-old lady with a long-standing goiter with concomitant thymoma. She underwent the surgery and developed respiratory distress upon extubation with loss of laryngeal sensation causing severe aspiration. She was diagnosed myasthenia gravis and symptoms resolved with MG treatments.

Matched MeSH terms: Thymus Neoplasms

Fulltext Follicular thyroid carcinoma in a patient with myasthenia gravis and thymoma: a rare association

Ni H, Htet A

Ecancermedicalscience, 2012;6:274.

PMID: 23074376 DOI: 10.3332/ecancer.2012.274

Myasthenia gravis (MG) is an autoantibody-mediated disorder affecting the neuromuscular junction causing characteristic fatigable muscle weakness. Though it can be associated with tumours of the thymus as well as thyroid disorders, it is rare for both to coexist. The exact prevalence of thyroid carcinoma in MG with thymoma is not known but only about a dozen cases have been reported in the literature. We report a case of a 38-year-old Myanmar lady who presented with weakness and breathlessness due to MG with neck swelling. On examination, she had fatigable proximal muscle weakness and thyroid enlargement with no obvious features of hyperthyroidism. Mediastinal widening and an enlarged thyroid gland were noted on her chest X-ray and chest CT. A subtotal thyroidectomy and thymectomy were done. The histology showed follicular carcinoma of the thyroid and benign thymoma. The majority of the reported cases of thyroid carcinoma in association with MG were papillary carcinoma. Follicular carcinoma thyroid associated with MG has not yet been reported in the literature.

Matched MeSH terms: Thymus Neoplasms

Histopathological study of carcinoma showing thymus-like differentiation (CASTLE)

Okubo Y, Sakai M, Yamazaki H, Sugawara Y, Samejima J, Yoshioka E, et al.

Malays J Pathol, 2020 08;42(2):259-265.

PMID: 32860379

INTRODUCTION: Carcinoma showing thymus-like differentiation (CASTLE) is a rare tumour that mainly arises from the thyroid gland, or occasionally, from the head and neck. Although the 10-year survival rate of patients with CASTLE is approximately 80%, local recurrence and distant metastasis are observed in some cases. A recent systematic review for CASTLE indicated that the prognostic factors are treatment-dependent, and postoperative radiotherapy significantly improves patient survival.

CASE REPORT: Herein, we describe and compare three cases of CASTLE, including a case with distant metastasis despite administering postoperative chemotherapy. Thus, the mechanisms underlying metastasis of CASTLE are unclear. This case study helps to elucidate the histopathological risk factors of metastasis in CASTLE.

DISCUSSION: We found that prominent lymphovascular invasion and higher proliferative activities might be risk factors of metastasis in CASTLE. In addition, we have summarised the cytological, morphological, and immunohistochemical features of CASTLE for an accurate diagnosis.

Matched MeSH terms: Thymus Neoplasms

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