1/7. A patient with thymoma and four different organ-specific autoimmune diseases.This is the first report of a patient with four organ-specific autoimmune diseases; myasthenia gravis, type 1 diabetes mellitus, autoimmune hepatitis and Hashimoto's thyroiditis. The clinical history suggests a relationship with a non-removed thymoma. Not only the thymoma seems to have triggered these four diseases, the dramatic progressive course with an active autoimmune hepatitis and high concentrations of multiple autoantibodies was probably also associated with non-removal of the thymoma. thymectomy should be performed in myasthenia gravis patients with thymoma and associated autoimmune diseases.- - - - - - - - - - ranking = 1keywords = thyroiditis (Clic here for more details about this article) |
2/7. Complete remission of pure white cell aplasia associated with thymoma, autoimmune thyroiditis and type 1 diabetes.Pure white cell aplasia (PWCA) is a rare disorder of unknown origin, often associated with thymoma, characterized by selective neutropenia or pure agranulocytosis, and absence of granulocyte precursors in the bone marrow, but with normal erythroblasts and megakaryocytes. We report a case of PWCA associated with thymoma. Unusual findings in this case report included simultaneous presence of autoimmune thyroiditis, type 1 diabetes, anti-striated muscle antibodies, and the presence in the peripheral blood of CD8 T cells that expressed a homogeneous naive phenotype. Neutrophil count became normal on immunosuppressive therapy after thymectomy.- - - - - - - - - - ranking = 26.297925449587keywords = autoimmune thyroiditis, thyroiditis (Clic here for more details about this article) |
3/7. Invasive cervical thymoma masquerading as a solitary thyroid nodule. Report of a case studied by fine needle aspiration.A 49-year-old woman underwent fine needle aspiration (FNA) biopsy of a presumed thyroid nodule. The initial cytopathologic interpretation suggested a chronic lymphocytic thyroiditis or a malignant lymphoma. The examination of frozen sections during surgery also suggested the presence of a lymphoma. However, histopathologic examination of permanent sections showed the lesion to be an invasive ectopic lymphocyte-predominant thymoma adjacent to the thyroid. Immunoperoxidase staining of FNA cell block sections and permanent sections showed positivity for keratin, proving the epithelial nature of the elongated and spindle-shaped tumor cells. This case high-lights the need to be aware of unusual lesions that may occur in the area of the thyroid; recognizing the potential diversity of "thyroid" masses that ultimately prove to be of nonthyroid origin should aid in making the correct cytologic differential diagnosis and interpretation of FNA samples obtained from such masses.- - - - - - - - - - ranking = 1keywords = thyroiditis (Clic here for more details about this article) |
4/7. Cervical thymoma.A 45-year-old woman presented with a five-year history of neck swelling and occasional difficulty in swallowing. The clinical impression was of a thyroid nodule, and fine-needle aspiration biopsy cytology revealed a monotonous lymphoid population, raising the suspicion of Hashimoto's thyroiditis. At surgery, the mass was identified at the level of the cricoid cartilage, displacing the right lobe of the thyroid gland superiorly and extending posteriorly to the prevertebral fascia. Although a frozen-section diagnosis of malignant lymphoma had been suggested at the time of surgery, permanent sections favored a diagnosis of thymoma. Surface marker studies showed the majority of cells to be of thymic T-cell phenotype, and ultrastructural examination demonstrated a dual population of lymphoid and epithelial cells, thus confirming the presence of thymoma. Cervical thymomas are extremely rare and this case report illustrates the difficulties in diagnosis; we speculate that cervical thymoma may be an underdiagnosed entity.- - - - - - - - - - ranking = 1keywords = thyroiditis (Clic here for more details about this article) |
5/7. recurrence of thymoma with appearance of myasthenia gravis 18 years after surgery: a case report.A 59-year-old woman was admitted to the hospital because of recurrence of thymoma with appearance of myasthenia gravis 18 years after excision of an invasive thymoma. recurrence was observed in the anterior mediastinum, right pleura, pericardium and left supraclavicular lymph node. Hashimoto's thyroiditis, vitiligo vulgaris and leukopenia were also seen. After creation of a pericardial window for pericardial effusion, she received vincristine, then carbazilquinone intravenously as single chemotherapeutic agents based on the chemosensitivity by clonogenic assay of the supraclavicular tumor, but response was not achieved. At one and a half years after radiotherapy to the mediastinum, she is now doing well without symptoms and is receiving a fairly low dose of anticholinesterase medication.- - - - - - - - - - ranking = 1keywords = thyroiditis (Clic here for more details about this article) |
6/7. Silent thyroiditis after excision of a thymoma.A 61-year-old man developed thyrotoxicosis after excision of a thymoma. His laboratory examination showed an increased level of thyroid hormone and a low thyroidal iodine uptake. No thyroidal autoantibody was detected. With the diagnosis of silent thyroiditis, he was treated with propranolol. He became euthyroid after 2 months. thymoma often accompanies an autoimmune disease as a paraneoplastic syndrome, and an immunological mechanism is thought to be involved in the onset of silent thyroiditis. This case suggests the involvement of an immunological mechanism in the pathogenesis of silent thyroiditis.- - - - - - - - - - ranking = 7keywords = thyroiditis (Clic here for more details about this article) |
7/7. Aspiration cytology of ectopic cervical thymoma mimicking a thyroid mass. A case report.BACKGROUND: Ectopic cervical thymoma, first described in 1941 by Boman, is an uncommon tumor of the neck displaying the same histologic features as mediastinal thymoma. Since it is commonly located in the anterolateral part of the neck or is subjacent to or inside the lower pole of the thyroid, the mass is often confused as being of thyroid origin. CASE: A 68-year-old female presented with dyspnea and an anterior neck mass found on routine chest roentgenography. The thyroid scan showed a cold nodule in the lower pole of the left part of the thyroid. Fine needle aspiration (FNA) cytology revealed large numbers of small lymphocytes with hyperchromatic nuclei and frequent clumping pattern in the pale, eosinophilic, fluid background. A few clusters of epithelial cells without atypism were interpreted as thyroid follicular cells. The overall cytologic features were misinterpreted as malignant lymphoma of the thyroid. However, the histologic diagnosis was thymoma, predominantly cortical type. CONCLUSION: The ectopic cervical thymoma is sometimes misdiagnosed as Hashimoto's thyroiditis, anaplastic carcinoma and malignant lymphoma of thyroid on FNA cytology or frozen diagnosis due to its rarity. Therefore, the differential diagnosis of a neck mass showing a variable composition of lymphocyte and epithelial component in a pale, eosinophilic, fluid background should also include ectopic cervical thymoma, especially in elderly females.- - - - - - - - - - ranking = 1keywords = thyroiditis (Clic here for more details about this article) |