Uner A H, Abali H, Engin H, Akyol A, Ruacan S, Tan E, Güllü I, Altundağ K, Güler N
Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.
Leuk Lymphoma. 2001 Jul;42(3):527-31. doi: 10.3109/10428190109064612.
Myasthenia gravis (MG) is an autoimmune neuromuscular junction disease. An association between thymic epithelial neoplasms and MG is well known. However, it is rarely associated with hematologic malignancies. In particular, very few cases of lymphoblastic lymphoma involving the thymus and MG have been reported. Here we report a case T-cell lymphoblastic lymphoma involving the thymus who developed MG after the initial diagnosis. The patient initially presented with a mediastinal mass which was diagnosed as lymphoblastic lymphoma. MG was diagnosed during leukemic relapse in this patient and was based on clinical presentation and neurophysiologic studies including single fiber electromyography (EMG) and repetitive nerve stimulation tests. In contrast to the other cases with such an association, the myasthenic symptoms presented nine months after the diagnosis of lymphoma by thymectomy. The patient had a highly aggressive clinical course and was resistant to various chemotherapy regimens.
重症肌无力（MG）是一种自身免疫性神经肌肉接头疾病。胸腺上皮肿瘤与MG之间的关联已为人熟知。然而，它很少与血液系统恶性肿瘤相关。特别是，涉及胸腺和MG的淋巴细胞淋巴瘤病例报道极少。在此，我们报告一例初诊为胸腺T细胞淋巴细胞淋巴瘤，初始诊断后发生MG的病例。该患者最初表现为纵隔肿块，诊断为淋巴细胞淋巴瘤。该患者在白血病复发期间被诊断为MG，诊断依据是临床表现以及包括单纤维肌电图（EMG）和重复神经电刺激试验在内的神经生理学研究。与其他有此关联的病例不同，该患者在胸腺切除术后诊断淋巴瘤九个月后出现肌无力症状。该患者临床病程进展迅速，对多种化疗方案均耐药。
