Wolf N, Husemann B, Druschky K F
Langenbecks Arch Chir. 1986;369:157-61. doi: 10.1007/BF01274342.
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.
对于所有胸腺肿瘤病例，胸腺切除术都有绝对指征。然而，即使采用现代影像学方法，术前也并非总能区分良性和恶性病变。对于可切除性存疑的广泛肿瘤，建议术前进行经胸针吸活检（在计算机断层扫描引导下）。确立组织学诊断后，可考虑术前放疗和/或化疗。某些免疫性疾病是胸腺切除术的相对指征。其在重症肌无力中的价值已得到证实，但在溃疡性结肠炎和红细胞生成减少症中的价值存疑。系统性红斑狼疮是禁忌症。
