Wang Junyan, Li Hua, Xie Xiaomei
Department of Pediatric Gastroenterology, Second Hospital of Lanzhou University, Lanzhou, China.
Radiol Case Rep. 2024 Oct 3;19(12):6652-6656. doi: 10.1016/j.radcr.2024.09.103. eCollection 2024 Dec.
The thymus, a vital immune organ in humans, plays a crucial role in the differentiation and development of T cells. Its normal development commences around the fourth week of gestation, originating from the ectoderm of the third branchial cleft and the endoderm of the third parotid pouch. By the 7-8th week of gestation, the primary thymus migrates towards the central axis. However, various factors may disrupt this process, leading to congenital anomalies such as incomplete descent of thymus tissue. Persistence of residual thymus tissue can result in the formation of ectopic thymus. Although ectopic thymus is rare in clinical practice, sporadic cases have been reported in the neck or mediastinum, with fewer occurrences in the pericardium, chest wall, axilla, and thyroid gland. It is estimated that ectopic thymus accounts for approximately 0.4% of neck masses, and improper removal may predispose the child to immune deficiencies. This article focuses on a neonatal patient presenting with respiratory failure, where a foreign body was discovered in the oral cavity during weaning from mechanical ventilation. Subsequently, the tumor progressively enlarged postextubation. Surgical excision of the tumor revealed pathological abnormalities upon hematoxylin-eosin (HE) staining, confirming ectopic thymus tissue. B-ultrasound examination confirmed the presence of thymus tissue, and the child's condition improved, leading to hospital discharge. Follow-up assessments showed no evidence of immune deficiency in the child.
胸腺是人体重要的免疫器官,在T细胞的分化和发育中起关键作用。其正常发育始于妊娠第4周左右,起源于第三鳃裂的外胚层和第三腮腺囊的内胚层。到妊娠第7 - 8周时,初级胸腺向中轴线迁移。然而,多种因素可能会干扰这一过程,导致先天性异常,如胸腺组织下降不全。残余胸腺组织的存留可导致异位胸腺的形成。虽然异位胸腺在临床实践中较为罕见,但颈部或纵隔的散发病例已有报道,在心包、胸壁、腋窝和甲状腺中的发生率较低。据估计,异位胸腺约占颈部肿块的0.4%,不当切除可能使儿童易患免疫缺陷。本文重点介绍了一名新生儿患者,该患者在机械通气撤机过程中口腔内发现异物,随后拔管后肿瘤逐渐增大。肿瘤手术切除后经苏木精-伊红(HE)染色显示病理异常,证实为异位胸腺组织。B超检查证实存在胸腺组织,患儿病情好转并出院。随访评估显示患儿无免疫缺陷迹象。