Hyperplasia of the thymus gland.
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Disease↗
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Results for “THYMUS HYPERPLASIA”
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Thymectomy in late-onset myasthenia gravis.
Between 1977 and 1979, 12 consecutive patients with myasthenia gravis who were over the age of 55 years were treated by thymectomy. In all, their conditions improved clinically; 11 of the 12 became free of the generalized features of myasthenia gravis. Nine patients required no further medication. Acetylcholine-receptor antibody titers did not change significantly. Although five patients had atrophic thymus glands, their conditions also improved. We conclude that (1) thymectomy is a safe and effective therapy for patients with myasthenia gravis who are over the age of 55 years; (2) steroids and anticholinesterase agents are not essential in the management of late-onset myasthenia gravis; and (3) reduction in acetylcholine-receptor antibody titer is not essential for beneficial clinical response.
Aged↗
Thymic tumors. Classification and treatment.
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Adult↗
A case of Perlman syndrome: fetal gigantism, renal dysplasia, and severe neurological deficits.
We report on a neonate presenting with polyhydramnios; macrosomia; macrocephaly; visceromegaly including bilateral nephromegaly, hepatomegaly, cardiomegaly; thymus hyperplasia; cryptorchidism; generalized muscle hypotonia; and a distinctive facial appearance. The clinical course was marked by severe neurodevelopmental deficits combined with progressive respiratory decompensation leading to death at the age 6 months. Magnetic resonance imaging (MRI) disclosed a generalized cerebral atrophy with a marked deficit of the white matter. Renal ultrasound and MRI showed markedly enlarged kidneys with multiple small cystic lesions, a pattern indistinguishable from polycystic kidney disease. The postmortem kidney biopsy revealed dysplastic changes, microcysts, and a focal nephrogenic rest, characteristic features of the Perlman syndrome. In children with fetal gigantism, renal abnormalities, and neurological deficits, Perlman syndrome should be considered and may be confirmed by kidney biopsy.
Abnormalities, Multiple↗
Thymic lymphocytes in myasthenia gravis.
Lymphocytes from the thymus glands of myasthenic patients and controls were characterized in terms of their percentages of B- and T-cells and their ability to stimulate the proliferation of autologous peripheral blood lymphocytes. Percentages of B- and T-cells were the same in the thymuses of myasthenic and control subjects. Autologous peripheral lymphocyte stimulation by thymocytes was observed in only 1 of 3 myasthenic patients, and this was with a thymus gland containing a thymoma. These results thus differ from those of other investigators.
B-Lymphocytes↗
Thymic hormone-containing cells VI. Immunohistologic evidence for the simultaneous presence of thymulin, thymopoietin and thymosin alpha 1 in normal and pathological human thymuses.
The localization of the three best-defined thymic hormones, namely, thymulin, thymopoietin and thymosin alpha 1 was studied by immunofluorescence using antibodies directed against these three molecules. With both human thymus frozen sections and cultured cells, thymic hormones were found exclusively in the epithelial component (recognized by its keratin content), in normal as well as pathological thymuses. The double-labeling experiments using the different anti-thymic hormone antibodies showed that the same epithelial cells contained the three hormones. These results suggest that the production of different hormones in the thymus is accomplished by the same epithelial cells.
Cells, Cultured↗
Thyroid and thymic malignancy following childhood irradiation.
Synchronous thyroid and thymic malignancy following childhood thymic irradiation has only been reported in two known cases previously, with a third case identified here. A rationale is presented for following these radiated patients as they age with thyroglobulin and thyroid-stimulating hormone (TSH) levels as a measure of risk of the development of nodular thyroid disease and, if such occurs, for an aggressive surgical approach. There exists a growing population at risk attributable to the success of radiation treatment of Hodgkin's and pediatric head and neck tumors. The question is raised regarding the theoretical benefits of thyroid suppressive therapy in this group at risk. With the instructive case presented, radical surgery for either thymic or thyroid carcinoma and careful monitoring for decades-late local recurrences of thymoma are suggested.
Adult↗
Follow-up study of myasthenic children after thymectomy.
The results of thymectomy of 28 myasthenic children observed from 1 to 9 years after operation are discussed. Improvement was obtained in 19 cases (67.8%), with full remission in 12 cases (42.8%). Six children died. No correlation was found between the results of thymectomy and the duration of the disease, sex or histological findings in the thymus. No increase of incidence or severity of infections were observed in thymectomized children. Caution is recommended regarding vaccination of myasthenic children.
Adolescent↗
Myasthenia gravis, thymectomy, and antiacetycholine receptor antibody.
The antiacetylcholine receptor antibody was titered in the serum of 63 patients with myasthenia gravis (MG) and 20 control healthy subjects. The titer was significantly high in 92% of MG patients in contrast with none of the controls and no correlation was found with the thymus pathology and the severity of the disease. The titer decreased after thymectomy almost steadily with the improvement of the myasthenic signs. The role of the antibody in the pathogenesis of the disease is discussed.
Acetylcholine↗
[Indications for thymectomy].
An absolute indication for thymectomy exists in all cases with tumors of the thymus gland, however, preoperative differentiation between benign and malignant lesions is not always possible even with modern imaging methods. In extensive tumors of questionable operability preoperative transthoracic needle biopsy (guided by CAT-scan) is recommended. After establishing the histological diagnosis, preoperative radio- and/or chemotherapy can be considered. Certain immunological diseases are a relative indication for thymectomy. Its value is proven in myasthenia gravis, questionable however in ulcerative colitis and erythroblastopenia. Systemic lupus erythematosus is a contraindication.
Autoimmune Diseases↗
Surgical treatment of myasthenia gravis and evaluation of its efficacy.
This paper reports 30 cases of myasthenia gravis (MG) treated by thymectomy from 1965 to 1990 in our hospital. Of all the 30 cases of MG, peripheral blood lymphocyte subpopulation was determined in 10, and anti-acetylcholine receptor antibody titer in 6, before and after operation. The results demonstrated the efficacy of thymectomy against MG. We considered that with application of hormone before and after operation to regulate immune function of the body, and/or with plasma exchange to remiss symptoms, all the patients with generalized MG may be indicated for treatment by thymectomy. Indication of treatment does not depend on age, sex and the course of the disease. But radical operation, proper anesthesia and appropriate use of antibiotics may ensure safety of the operation and its curative effect.
Adolescent↗
Mediastinal cysts and tumors.
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Diagnosis, Differential↗
Giant thymolipoma in a child.
Thymolipoma, a rare benign mediastinal tumor, was found in a 6-year-old boy. Computed tomography scans, magnetic resonance imaging, and angiography of internal thoracic artery confirmed the diagnosis before surgery.
Adipose Tissue↗
Immunocytochemical localization of thymosin-alpha 1 in thymic epithelial cells of normal and myasthenia gravis patients and in thymic cultures.
Thymosin alpha 1 (alpha 1) is a potent thymic polypeptide hormone. With antibodies against synthetic thymosin alpha 1, indirect immunofluorescence was applied to human normal thymus and to hyperplastic, thymomatous or "involuted" thymus of myasthenia gravis (MG) patients. Alpha 1 was localized only in the epithelial cells, lying singly, grouped, in Hassall's corpuscles or proliferated in thymomas. In contrast to normal thymus, which had fewer and more weakly stained cells, MG hyperplastic thymus had many strongly positive epithelial cells: this was markedly evident in thymomas. "Involuted" MG thymus had a few but brightly stained cells lying within the fatty tissue. In tissue cultures of human thymus, anti-alpha 1 stained the epithelial cells, but not fibroblasts. These findings: (a) demonstrate the origin of the thymic hormone alpha 1 to be the thymic epithelial cell; (b) raise the possibility that excess alpha 1 may act pathologically to facilitate and perpetuate the dysimmune mechanism in MG; (c) may partially explain the beneficial effect of thymectomy in MG patients of any age; and (d) suggest that epithelial cells may be autonomous for the production of alpha 1 as evidenced by their positivity in tissue culture.
Adolescent↗
Primary cultures of human myasthenia gravis thymus and normal thymus. Studies of cell morphology, cell proliferative pattern and localization of alpha-bungarotoxin binding sites on cultured thymic cells.
We have established primary cultures of human myasthenia gravis (MG) thymuses and normal thymuses. In cultures of 19 thymuses with hyperplasia among 23 MG thymuses and 12 thymuses among 13 normal thymuses, epithelial cells migrated in a mosaic-like arrangement and were maintained for more than 5-10 weeks. There were, among mononuclear epithelial cells, some multinucleated cells, some of which were considered to be derived from epithelial cells because they had a desmosome-like structure and contained tonofilaments in their cytoplasm. There was no significant difference in the morphology of epithelial cells between MG thymuses and normal thymuses. The growth rate of thymic epithelial cells was identified by [3H]thymidine autoradiography(ARG), labeling indices rising to a peak around a week and falling to low levels gradually. There was no significant difference in the growth rate of epithelial cells between MG thymuses and normal thymuses. An autoradiographic method with 125I-labeled alpha-bungarotoxin was used to detect the presence of acetylcholine receptor (AChR) on the cultured cells. ARG of human MG thymuses and normal thymuses, which were cultured for 4 weeks, revealed diffusely distributed silver grains on the epithelial cells. Toxin binding sites (AChRs) were considered to be present on the epithelial cells. There was no significant difference in the distribution of AChR on the epithelial cells between MG thymuses and normal thymuses.
Adolescent↗
Association of autoantibodies and pathological changes in aged Praomys (Mastomys) natalensis.
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Aging↗
Primary anterior mediastinal tumors in children and adults.
This review details pertinent anatomical, radiological, pathological, and clinical information regarding primary anterior mediastinal tumors. Although the majority of these lesions are included in one of several subgroups, for example, thymic tumors, teratomas, or thyroid abnormalities, other less common entities will occasionally be encountered by the practicing surgeon. Likewise, there are variations in the frequency distribution of anterior mediastinal lesions in children as opposed to adults. Management of these individual lesions is outlined.
Adult↗