Salvado de Carvalho Inês, Baldo Maria João
Internal Medicine, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Guarda, PRT.
Cureus. 2025 Jul 10;17(7):e87665. doi: 10.7759/cureus.87665. eCollection 2025 Jul.
Thymic hyperplasia is a rare and benign cause of mass in the anterior mediastinum in adults. This pathology is characterized by an increase in the size and weight of the thymus while preserving its architecture and histology. In most cases, it is asymptomatic, and routine imaging exams are used to make the diagnosis. Thymic hyperplasia can be divided into reactive and true hyperplasia based on morphological characteristics. The main differential diagnosis of this pathology is thymoma, an epithelial neoplasm of the thymus. True thymic hyperplasia is the rarest subtype, and, unlike reactive or lymphofollicular, it does not present histologically with lymphoid follicles and is not associated with autoimmune diseases, such as myasthenia gravis and Graves' disease. Here we present the case of an adult patient with thymic hyperplasia incidentally diagnosed in imaging exams. The established treatment was complete surgical resection, which is indicated as the first-line treatment. Subsequent histopathological analysis confirmed a diagnosis of true thymic hyperplasia.
胸腺增生是成人前纵隔肿物的一种罕见的良性病因。这种病理表现为胸腺大小和重量增加，但其结构和组织学保持正常。在大多数情况下，它是无症状的，常规影像学检查用于做出诊断。根据形态学特征，胸腺增生可分为反应性增生和真性增生。这种病理的主要鉴别诊断是胸腺瘤，一种胸腺上皮性肿瘤。真性胸腺增生是最罕见的亚型，与反应性或淋巴滤泡性增生不同，它在组织学上不出现淋巴滤泡，也不与自身免疫性疾病如重症肌无力和格雷夫斯病相关。在此，我们报告一例在影像学检查中偶然诊断为胸腺增生的成年患者。既定的治疗方法是完整的手术切除，这被视为一线治疗方法。随后的组织病理学分析证实诊断为真性胸腺增生。
