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Thymic Lesion

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Overview Thymic tumors occupy the anterior mediastinum, which is immediately posterior to the sternum and the anterior surface of the pericardium and great vessels. Tumors of thymic, lymphatic, or germ cell origin most commonly occur in this compartment, although aberrant parathyroid or thyroid tissue masses are sometimes found, along with vascular and mesenchymal tissue masses. (See the images below.) Fairly large thymus in an infant.  View Media Gallery Gross appearance of a thymoma showing distinct multinodularity and scattered, focal cystic changes.  View Media Gallery Thymolymphoma. Chest radiograph shows a large, lobulated mediastinal mass.  View Media Gallery About one half of all thymic tumors are malignant in individuals aged 20-40 years, and one third are malignant in persons younger than 20 years and those older than 40 years. (A malignant thymic tumor is seen in the image below.) Malignant thymoma. Chest CT scan in a 61-year-old man with myasthenia gr
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Radiography

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Many thymomas may be visualized using routine chest radiographs in posteroanterior (PA) and lateral views. A thymoma frequently appears as a smooth, lobulated mass in the superior aspect of the anterior mediastinum, often projecting into one of the hemothoraces. The mass may be calcified or cystic. (See the images below.) Low-lying thymoma. Plain chest radiograph shows a mass lying against the right heart border.  View Media Gallery Thymolymphoma. Chest radiograph shows a large, lobulated mediastinal mass.  View Media Gallery In most cases, thymolipomas are detected incidentally on chest radiographs. They are often large, ranging up to 36 cm in diameter (mean, 18 cm) at the time of diagnosis. Thymolipomas may project into the hemithoraces; they may be seen draping over the heart and extending as far as the costophrenic angles. They can be easily mistaken for pleural or pericardial tumors or even pulmonary sequestration.
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Anti-LRP4 Autoantibodies

Abstract INTRODUCTION:  We assessed antibodies against low-density lipoprotein receptor-related protein 4 (LRP4-Ab) in a Chinese population with myasthenia gravis (MG). METHODS:  Serum samples from 116 patients and 80 controls were collected. Acetylcholine receptor antibodies(AChR-Ab) and muscle-specific receptor tyrosine kinase antibodies (MuSK-Ab) were tested using an enzyme-linked immune absorption assay, and LRP4-Ab was identified using a cell-based assay. MG patients with neither AChR-Ab nor MuSK-Ab were defined as double-seronegative MG (dSN-MG). RESULTS:  Two of 116 (1.7%) of all patients and 2 of 50 (1%) dSN-MG patients were positive for LRP4-Ab. These 2 patients had ocular MG. Following treatment with acetylcholinesterase inhibitor and prednisone, both achieved full remission. CONCLUSIONS:  This study shows that LRP4-Ab is a pathogenic antibody in MG. LRP4-MG seems to be characterized by mild disease severity and favorable therapeutic effect in contrast with other
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