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Thymic Lymphoma

Image
On CT scans, the thymus is enlarged, symmetrically or asymmetrically; this enlargement often makes it difficult to differentiate the thymus from the enlarged surrounding lymph nodes. At times, differentiating the thymus from a thymoma is difficult, although the clinical picture and the presence of other sites of lymphadenopathy are often helpful in the diagnosis. (See the image below.) Thymolymphoma. Contrast-enhanced CT scan demonstrates a large, lobulated, soft tissue mass in the anterior mediastinum that posteriorly displaces the aorta and pulmonary artery.  View Media Gallery
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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 ...
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X-Ray

Between 25% to 50% of thymomas are undetectable on PA chest radiographs [6,12]. CT scan is the study of choice in the evaluation of patients with myesthenia gravis or a suspected thymoma [12]. CT has a sensitivity of 91% and a specificity of 97% for the diagnosis of a thymic mass [12]. MR adds little additional information. Note: The use of iodinated contrast agents in patients with myasthenia gravis has been reported to cause increased weakness. Although not contraindicated, intravenous contrast agents should not be used routinely in the assessment of these patients. [1]  On CT, thymomas appear as a lobulated, well-defined, soft tissue density mass with rounded margins in the anterior mediastinum and growth is usually to one side. Mild, homogeneous contrast enhancement is characteristic. Calcification is common (20% of cases on plain film). Cystic areas (due to hemorrhage or necrotic degeneration) are also found in 20-30% and these are typically larger lesions. A clue to the...
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