Fouda Ashraf, Kandil Shaimaa, Hamid Gihad, Boujettif Khadijah, Mahfouz Mohamed, Abdelaziz Mohamed
Departamento de Pediatría, Facultad de Medicina, Hospital Infantil de la Universidad de El Mansura, Universidad de El Mansura, El Mansura, Egipto.
Departamento de Pediatría, Facultad de Medicina, Hospital Infantil de la Universidad de El Mansura, Universidad de El Mansura, El Mansura, Egipto.
An Pediatr (Engl Ed). 2019 Sep;91(3):189-198. doi: 10.1016/j.anpedi.2018.10.021. Epub 2019 Feb 1.
Thymic regrowth after chemotherapy treatment has been reported in children with lymphoma, and in order to avoid misdiagnosing these cases as relapses, physicians should become familiar with rebound (reactive) thymic hyperplasia (RTH) and remain aware of its possible occurrence. We aimed to estimate the prevalence of RTH in children with lymphoma after completion of chemotherapy and to evaluate the clinical characteristics, outcomes, and the findings of computed tomography (CT) and gallium-67 (GA-67) scans in these patients.
We conducted a retrospective cross-sectional study by reviewing the health records of children with a lymphoma diagnosis managed at an outpatient paediatric oncology clinic in Jeddah, Saudi Arabia.
Rebound thymic hyperplasia was detected in 51.9% of the lymphoma patients (14/27). It developed a median of 2.5 months after completion of chemotherapy (range, 2.0-4.25 months). Patients with RTH had significantly shorter treatment durations, and we found no significant differences between patients with and without RTH in sex, age at diagnosis, type of lymphoma or type of treatment received. All patients with RTH were asymptomatic, and routine laboratory tests did not detect any abnormalities in them. The findings of CT and GA-67 scans were highly suggestive of RTH. None of the patients with RTH had a recurrence, and RTH resolved spontaneously within a median of 6 months (range, 4.0-11.0).
RTH was detected in ∼50% of children with lymphoma after completion of chemotherapy. A clinical evaluation and laboratory tests combined with imaging by CT and GA-67 can help identify RTH and rule out other lesions elsewhere.
已有报道称淋巴瘤患儿化疗后胸腺会再生，为避免将这些病例误诊为复发，医生应熟悉反弹（反应性）胸腺增生（RTH）并随时留意其可能出现的情况。我们旨在评估化疗结束后淋巴瘤患儿中RTH的患病率，并评估这些患者的临床特征、预后以及计算机断层扫描（CT）和镓-67（GA-67）扫描的结果。
我们通过回顾沙特阿拉伯吉达一家儿科肿瘤门诊所诊治的淋巴瘤患儿的健康记录，进行了一项回顾性横断面研究。
在51.9%的淋巴瘤患者（14/27）中检测到了反弹胸腺增生。它在化疗结束后中位数2.5个月时出现（范围为2.0 - 4.25个月）。患有RTH的患者治疗时间明显更短，并且我们发现有RTH和无RTH的患者在性别、诊断时年龄、淋巴瘤类型或接受的治疗类型方面没有显著差异。所有患有RTH的患者均无症状，常规实验室检查未发现他们有任何异常。CT和GA-67扫描结果高度提示为RTH。没有RTH患者出现复发，RTH在中位数6个月内（范围为4.0 - 11.0）自发消退。
化疗结束后约50%的淋巴瘤患儿检测到RTH。临床评估、实验室检查以及CT和GA-67成像有助于识别RTH并排除其他部位的病变。
