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PubMedDate not supplied

[Hyperplasia of the thymus gland in children: physiology or pathology?].

A critical analysis of the literature data and of the results of clinicoroentgenological, hormonal and immunological studies in children with thymomegaly makes it possible to regard hyperplasia of the thymus gland at early childhood as a sign of functional incompetence of the thymus and of the secondary immunodeficient state.

Adrenal Insufficiency↗
PubMed1989

Histiocytosis X and lymphoid follicular hyperplasia of the thymus in myasthenia gravis.

A case of a myasthenic patient with the association of unifocal histiocytosis X (eosinophilic granuloma) and lymphoid follicular hyperplasia of the thymus is presented. The combined diagnosis was made on histological grounds and supported by immunohistochemistry. Two aspects of this case are of interest: (1) it is the first reported case of the association of histiocytosis X and lymphoid follicular hyperplasia of the thymus in a myasthenic patient; and (2) the pathogenesis of this peculiar association does not seem to be fortuitous but rather might be related to the general derangement of the immune system present in myasthenia gravis.

Adult↗
PubMed2006

[Video-assisted, extended thymectomy for the treatment of myasthenia gravis. Our early experiences].

INTRODUCTION: Extended thymectomy is the key-point of the surgical treatment of the myasthenia gravis (MG), when the thymus with the surrounding fatty tissue on the neck and in the mediastinum is removed. In this study we present a new surgical technique introduced into our practice in November 2004, and with that the thymectomy is performed with video-thoracoscopic method, without sternotomy. PATIENTS AND METHODS: Since November 2004, 6 patients (5 females and 1 male) were operated on for MG. Mean age was 26.2 years (17-41). Symptoms of MG was only ocular in 1 case (Stage I) and mild generalized in 5 cases (Stage II/B). The average preoperative period of the MG was 4 months (1-12). At the beginning of the surgery, the superior poles of the thymus were exposed and the fatty tissue surrounding the thymus in front of the trachea was removed. After that, the sternum was elevated with sternal retractors inserted under the sternum in the cervical and in a subxiphoid incisions. The thymectomy with the removal of the mediastinal fatty tissue was performed with bilateral video-assisted method. RESULTS: Mean operative time was 170 (120-210) minutes. There was no conversion to sternotomy, and there were no mortality and serious morbidity. Patients were extubated in the operating room. Chest tubes were removed on the first and second postoperative days. Mean postoperative hospitalization was 6.3 (5-7) days. At the one-month follow-up, there was 1 complete remission and 5 remissions with medication. In 1 case, the pathology revealed extrathymic thymus tissue in the cervical fat. There were 3 thymus hyperplasias, 2 thymitis and 1 thymic cyst as the pathological disorders of the thymus. CONCLUSIONS: The video-assisted extended thymectomy for MG, that was introduced into our practice, is a safe surgical procedure with good results. The postoperative period is easier for the patients, and the MG was improved in each cases.

Adolescent↗
PubMedDate not supplied

A rare cause of respiratory distress in infants: tracheal compression due to anomalous course of innominate artery.

Incomplete vascular ring is a rare congenital vascular anomaly causing tracheal compression. A case of anomalous innominate artery causing tracheal compression and low grade tracheomalacia with remarkable dyspnea and intermittent apnea in a five-month-old infant is reported. Chest X-ray revealed enlarged upper mediastinum. Patent foramen ovale and thymus hyperplasia were detected on echocardiographic examination. Angiography demonstrated left aortic arch with normal arterial branching pattern. Thorax computerized tomography (CT) revealed tracheal compression of more than 50% at innominate artery level and aberrant position of the hyperplastic thymus. Operation was planned for subtotal thymectomy and relocation of innominate artery in order to relieve tracheal obstruction. Postoperative thorax CT demonstrated satisfactory relief of tracheal compression. Patient was discharged from hospital on sixth postoperative day in good condition. On clinical follow-up he is completely asymptomatic without any signs of dyspnea or intermittent reflex apnea. In severely symptomatic cases, surgical treatment offers excellent results.

Brachiocephalic Trunk↗
PubMed1989

Epithelial proliferation in thymic hyperplasia. An immunohistochemical study and correlation with the developing fetal thymus.

Thymic hyperplasia is a B-cell lymphoid proliferation in which an epithelial component has not, to our knowledge, been previously described. We present a case of thymic hyperplasia in which numerous lymphoid follicles with germinal centers were partially surrounded by small sheets of spindle and epithelioid cells. Electron microscopy confirmed the epithelial nature of these cells. Immunostaining was performed using antibodies to keratins, S100 protein, and two B-cell markers, LN1 and MB2. The proliferated epithelium stained only for high-molecular-weight keratin, whereas the lymphoid tissue stained positively for both B-cell markers. To determine the origin of the proliferated epithelium, the staining was compared with that of the developing fetal and normal adult thymus. We have shown that during fetal development, the keratin composition of thymic epithelium changes from staining predominantly with low- to high-molecular-weight keratin. The immunostaining characteristics of the epithelium in this case of thymic hyperplasia suggest an origin from adult-type epithelium. Furthermore, the association of S100-positive interdigitating reticulum cells with the proliferated epithelium suggests that it is of medullary origin. Our results indicate that epithelial proliferation can be an important component of thymic hyperplasia.

Aged↗
PubMed1989

Thymic abnormalities and autoimmune diseases.

Autoimmune diseases such as ulcerative colitis (UC) and myasthenia gravis (MG) are frequently associated with thymic abnormalities. Thymus hyperplasia and/or thymoma have been demonstrated in all cases with both of these two diseases by pneumomediastinography (PMG). In the diseases of digestive organs from which we can easily obtain the local information through the endoscopic observation and biopsy specimens, lots of immunological abnormalities have been accumulated. Antibody-dependent cell-mediated cytotoxicity mechanism has been demonstrated to play an important role in the mucosal destruction in UC. In the peripheral blood level of this disease, immunological abnormalities have been demonstrated such as the presence of lymphocytes sensitized by certain antigens, autoantibodies and disturbances of lymphocyte subpopulations. In the level of the thymus, the retrovirus has been detected in the thymus epithelial cells. The supernatant of thymus epithelial cell culture (STEC) has the capability of differentiating human bone marrow cells and of facilitating disease-specific immune abnormalities. Moreover, the serum factors (thymus growth factor) discovered in the patients with UC and MG, have been demonstrated to alter the thymic environments. Therefore, it is postulated that thymectomy is beneficial to exclude these abnormalities and it has been evaluated to be very effective in UC and MG clinically. From these observations, it is thought to be important to investigate the immunological abnormalities of autoimmune diseases from the viewpoints of three immunological levels, the level of disease-specific organ, the peripheral blood level and the level of the thymus. And it is important that the therapeutic plans should be decided in the consideration of the abnormalities in each immunological level.

Autoimmune Diseases↗
PubMed1981

Thymoma-specific antibodies in sera from patients with myasthenia gravis demonstrated by indirect haemagglutination.

An indirect haemagglutination technique for the demonstration of antibodies to skeletal muscle is described. Eight out of 9 sera from unoperated myasthenia gravis (MG) patients with thymoma and 6 out of 22 sera taken from MG patients who had been operated upon for a thymoma, contained antibodies to this antigen. Twenty-five sera from MG patients with histologically verified thymus hyperplasia did not contain such antibodies. There was no relationship between these antibodies and antibodies to acetylcholine receptor.

Autoantibodies↗
PubMed1977

Alloxan diabetes in spontaneously hypertensive rats: gravimetric, metabolic and histopathological alterations.

In order to investigate the combined effects of diabetes and hypertension on the pathogenesis of cardiovascular disease, adult male and female SHR rats which develop hypertension spontaneously were given a single, 10 mg or 15 mg/100 g body wt. injection of alloxan s.c. to induce moderate or severe diabetes. Insulin was deliberately withheld. Animals were examined by autopsy daily for 7 days post-alloxan and after 4 and 8 weeks. Mortality was high--only 52% of the males survived as against 80% of the females. Most deaths occurred on Day 5 and were associated with adrenal haemorrhage and hyperplasia, thymus galnd involution, fatty liver and marked hypotension despite elevated aldosterone levels. During the first week, corticosterone levels increased significantly in the male; in females they showed little change. After 4 weeks, the severly diabetic animals became emaciated and moribund; corticosterone and aldosterone levels fell to very low levels despite adrenal hyperplasia. The beta cells of the moderately diabetic animals eventually lost their ability to secrete insulin and these animals too became cachetic and moribund with concomitant elevation of lipid, glucose and BUN levels, as well as myocardial infarction, fatty liver, and generalized hyalin arteriolo-, arterio-, and nephrosclerosis. It is suggested that the combined hormonal and metabolic alterations of diabetes and hypertension reinforced one another in these spontaneously hypertensive rats, leading to intense stimulation of the hypothalamic-pituitary-adrenal system, the exacerbation of those cardiovascular degenerative changes known to be associated with uncontrolled diabetes or hypertension, eventual impaired adrenocortical steroidogenesis, hypotension and death.

Aldosterone↗
PubMed1982

Receptors for IgA on human thymus cells in myasthenia gravis.

Specific surface receptors for the Fc region of human immunoglobulin A (Fc alpha R) were identified on the thymus cells of all 15 patients affected by myasthenia gravis. A large variation of the percentage of Fc alpha R bearing thymus cells was recorded (9 . 5-66 . 0%; mean value 27 . 9 +/- 17 . 8) the high values being associated in most cases with the thymus hyperplasia and the low values with a lipomatosis of the organ. Even the lowest percentage of Fc alpha R bearing cells recorded in myasthenia gravis are considerably higher than those found in normal subjects (0 . 4-4 . 1; mean value 1 . 8) demonstrating that the expression of Fc alpha R on the thymus cells is the consequence of the disease. No attempts were made to identify the cell population bearing Fc alpha R but indirect results indicate that the cells belong to E-rosette forming population, and, in some cases, to a null cell population devoid of the ability to form E and EAC rosettes, Fc alpha R can bind various IgA ligands and the binding is confined to a small fraction of IgA (not more than 5%) considered as cytophilic IgA.

Absorption↗
PubMed1975

[Morphological and biochemical study of the organs of immunogenesis during the growth of established glioblastoma multiforme in albino rat brain].

Morphological changes in the lympho-reticular organs (the thymus, lymph nodes, spleen) were studied and the content of the RNA was determined by the biochemical method in 92 rats during the growth of the glioblastoma multiforme (strain 101/12) in the brain. The reaction of the organs of immunogenesis depended on the stage of the disease. On the 6th day after the transplantation of the tumour the increased activity of the epithelial-reticular portion of the thymus, hyperplasia of the follicles in the lymph nodes, and increased produciton of the RNA was observed. As to the tumour-bearing animals the destruction of the lymphoid elements and decreased synthesis of the RNA was noted. A giradual cell depletion of the spleen was revealed morphologically.

Animals↗
PubMed1990

Histopathological findings in harbour seals (Phoca vitulina) found dead on the German North sea coast.

Various organs--lung, trachea, liver, kidney, heart, adrenal gland, skin, spleen, thymus, lymph node, gut, thyroid, spinal cord and brain--were removed from 43 seals at dissections performed on the German North sea coast. The specimens were fixed in formalin and routinely processed for light microscopy. The major pathological findings were Lung: acute congestion with interstitial and intra-alveolar oedema; intra-alveolar haemorrhage; suppurative bronchitis and bronchopneumonia; larvae and adult forms of Parafilaroides gymnurus. Liver: acute congestion; granulomatous lesions and infiltrates of eosinophils; intravascular nematodes. Spleen: varying degrees of atrophy of the white pulp; haemosiderosis; acute congestion of the red pulp. Lymph nodes: varying degrees of atrophy of the lymphatic tissue; long-standing sinus histiocytosis with partial fibrotic obliteration of the lumina; parasitic infiltration, sometimes with the Splendore-Hoeppli phenomenon; germinal centre hyperplasia. Thymus: pronounced atrophy of the lymphatic tissue, particularly in the cortical areas. Thyroid: marked reduction in colloid content. The other organs studied were normal or showed only minor histopathological changes. The morphological findings do not allow definite conclusions to be made about the aetiology and pathogenesis of the illness and death of the seals. However, evidence has been published that the seals' illness is probably due to canine distemper virus. The atrophy of the lymphoreticular tissues is consistent with infection by this virus.

Animals↗
PubMed1987

CA-antibody: an immunological marker of thymic neoplasia in myasthenia gravis?

We have examined sera from 141 patients with myasthenia gravis and 11 non-myasthenia gravis patients with thymoma for antibodies to a citric acid extract of skeletal muscle (CA-antibodies). Sera were obtained from 5 different centers. The thymus histology was defined in each case. Sera from 56/66 patients (85%) with thymoma contained CA-antibodies, while such antibodies were only detected in 6/75 (8%) of the non-thymoma patients. None of the patients with thymus hyperplasia had CA-antibodies. One MG patient who developed MG after a bone-marrow transplantation, also developed CA-antibodies. The remaining 5 CA positive non-thymoma MG patients were all greater than 65 years and had thymic atrophy. Two of them had myasthenia gravis and polymyalgia rheumatica. In 2 thymoma patients with non-detectable levels of CA-antibodies before thymectomy, such antibodies were demonstrated in high titres after the operation. In 2 other sera from thymoma patients, the titres of CA-antibodies fell to less than 32 after thymectomy. There were 3 sera with CA-antibodies among 11 sera from non-MG patients with thymic tumours.

Antibodies↗