Yamaki Minoru, Nishina Mai, Noriyuki Toshio, Yonehara Syuji
Department of General Thoracic Surgery, Onomichi General Hospital, Onomichi, Japan.
Kyobu Geka. 2023 Feb;76(2):115-118.
Thymoma presenting concurrent pure red-cell aplasia (PRCA) and hypogammaglobulinemia are extremely rare. A 67-year-old woman with a short of breath was referred to our hospital due to anemia and the chest abnormal shadow. Laboratory investigations revealed a hemoglobin level of 5.6 g/dl and reticulocyte percentage of 0.2%. Her serum gamma-globulin level was low. Chest computed tomography (CT) revealed a 7-cm tumor in the left upper mediastinum. We diagnosed the patient with thymoma accompanied by PRCA and hypogammaglobulinemia. The patient underwent thymectomy and PRCA has been successfully treated by postoperative cyclosporine administration. Monthly intravenous infusion of gamma-globulin has been necessary for the control of hypogammaglobulinemia. Currently, she is doing well without recurrence of thymoma or PRCA five years after the surgery.
胸腺瘤并发纯红细胞再生障碍性贫血(PRCA)和低丙种球蛋白血症极为罕见。一名67岁呼吸急促的女性因贫血和胸部异常阴影被转诊至我院。实验室检查显示血红蛋白水平为5.6 g/dl,网织红细胞百分比为0.2%。她的血清γ-球蛋白水平较低。胸部计算机断层扫描(CT)显示左上纵隔有一个7厘米的肿瘤。我们诊断该患者为胸腺瘤伴PRCA和低丙种球蛋白血症。患者接受了胸腺切除术,术后通过环孢素给药成功治疗了PRCA。为控制低丙种球蛋白血症,每月需静脉输注γ-球蛋白。目前,术后五年她情况良好,胸腺瘤或PRCA均未复发。