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[胸腺切除术治疗合并纯红细胞再生障碍性贫血的胸腺瘤;1例报告]

[Thymothymectomy for the thymoma with pure red cell aplasia; report of a case].

作者信息

Ayabe Takanori, Matsuzaki Y, Edagawa M, Shimizu T, Hara M, Ninomiya H, Onitsuka T

机构信息

Department of Second Surgery, Miyazaki Medical College, Miyazaki, Japan.

出版信息

Kyobu Geka. 2004 Aug;57(9):905-9.

Abstract

UNLABELLED

We report a case of thymothymectomy for the thymoma with pure red cell aplasia (PRCA). A 31-year-old male with a general fatigue had a severe anemia (hemoglobin 3.1 g/dl) since November 1997. By the bone marrow examination, PRCA was diagnosed and treated with blood transfusion and immunosuppressive drug (cyclosporin: CYA) administration but anemia had not been improved. The chest computed tomography displayed a 3 cm in a diameter of thymoma located in the anterior mediastinum. The extended thymothymectomy had been performed in February 1998, pathological detection disclosed Masaoka classification stage I, type AB was diagnosed due to the World Health Organization (WHO) classification. PRCA had not obtained an immediate remission during the postoperative-early term, while, adjuvant therapy (CYA 300 mg/day) has been continued and it brought a complete remission of PRCA in August 2001 (after the postoperative 3 years and 6 months later).

CONCLUSIONS

Even though only thymothymectomy for thymoma with PRCA showed no effectiveness for the postoperative-early remission of PRCA, however, the combination of thymectomy and the postoperative adjuvant therapy (CYA) should bring a better outcome, and the continuous follow-up would be required for a long postoperative term.

摘要

未标注

我们报告一例因胸腺瘤合并纯红细胞再生障碍性贫血(PRCA)而行胸腺切除术的病例。一名31岁男性自1997年11月起出现全身乏力,并伴有严重贫血(血红蛋白3.1 g/dl)。经骨髓检查,诊断为PRCA,给予输血及免疫抑制药物(环孢素:CYA)治疗,但贫血未见改善。胸部计算机断层扫描显示前纵隔有一个直径3 cm的胸腺瘤。1998年2月行扩大胸腺切除术,病理检测显示为Masaoka分期I期,根据世界卫生组织(WHO)分类诊断为AB型。术后早期PRCA未立即缓解,继续辅助治疗(CYA 300 mg/天),并于2001年8月(术后3年6个月)实现PRCA完全缓解。

结论

尽管单纯胸腺切除术对合并PRCA的胸腺瘤术后早期缓解无效,但胸腺切除术与术后辅助治疗(CYA)联合应用应能带来更好的效果,术后仍需长期持续随访。

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