Viéitez M C, Aladró Y, Alemany M J, Amela R, Muñoz C, Santana N
Servico de Cirugía Torácica; Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, 35020, España.
Rev Neurol. 2001;32(12):1135-7.
Although the association between benign neoplasias of the thymus and myasthenia gravis is well known, with greater predominance of squamous thymomas over other histological types, carcinoma of the thymus is only exceptionally associated with auto immune disorders.
We present three patients with myasthenia gravis associated with carcinoma of the thymus. They were three men aged between 38 and 73 years. Clinical features of myasthenia were generalized in two cases and ocular only in the third. Antireceptor antibodies to acetylcholine and anti striped muscle antibodies were present in all three patients. Repetitive stimulation was abnormal in two of the three cases. On CAT of the thorax there was a tumour of the thymus with the radiological characteristics of a benign thymoma in two of the patients and data suggesting an invasive thymoma in the third. In all three cases the diagnosis of carcinoma of the thymus was made on the post operative histological findings.
The association of carcinoma of the thymus with myasthenia gravis in our series of cases was probably due to chance. We consider that this association is exceptional since the histological characteristics of carcinoma of the thymus do not favour the development of auto immunity.
虽然胸腺良性肿瘤与重症肌无力之间的关联已为人熟知,鳞状胸腺瘤比其他组织学类型更为常见,但胸腺肿瘤仅在极少数情况下与自身免疫性疾病相关。
我们报告3例重症肌无力合并胸腺肿瘤患者。患者均为男性,年龄在38至73岁之间。2例患者肌无力的临床特征为全身性,第3例仅为眼部症状。所有3例患者均存在抗乙酰胆碱受体抗体和抗横纹肌抗体。3例中有2例重复刺激试验异常。胸部计算机断层扫描(CAT)显示,2例患者的胸腺肿瘤具有良性胸腺瘤的放射学特征,第3例的数据提示为侵袭性胸腺瘤。所有3例均根据术后组织学检查结果诊断为胸腺肿瘤。
在我们的系列病例中,胸腺肿瘤与重症肌无力之间的关联可能是偶然的。我们认为这种关联极为罕见,因为胸腺肿瘤的组织学特征不利于自身免疫的发生发展。