Ayari Myriam, Ben Azouz Sarah, Chehaider Amira, Ben Rejeb Sarra, Jomni Taieb
Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, Tunisia.
Pathology Department, Internal Security Forces Hospital La Marsa, Tunis, Tunisia.
Future Sci OA. 2025 Dec;11(1):2560241. doi: 10.1080/20565623.2025.2560241. Epub 2025 Sep 11.
Chemotherapy, especially for malignant tumors, can affect the thymus, leading to its atrophy and a decreased production of naïve T lymphocytes. However, regenerative process can occur in children and rarely in adults manifesting as thymic hyperplasia. A 49-year-old female patient was diagnosed with stage I breast cancer. She was treated with surgery, adjuvant chemotherapy followed by radiotherapy and hormonotherapy. Follow-up computed tomography scan showed a mediastinal retro-sternal mass, raising concern for tumor recurrence. However, no other signs of relapse were evident. A thymic rebound was suspected, with the lesion presenting as a triangular-shaped mediastinal mass suggestive of thymic morphology and consisting of mixed fat and soft tissue density with smooth borders. Close monitoring was then decided. A follow-up CT scan of the chest showed regression of the mediastinal mass. The diagnosis of thymic rebound after chemotherapy was then retained. The patient is currently in remission, seven years from her original diagnosis of breast cancer. Thymic hyperplasia after chemotherapy can rarely occur in adults. Clinicians should be aware of this unusual presentation to prevent needless investigation and therapy.
化疗，尤其是针对恶性肿瘤的化疗，可影响胸腺，导致其萎缩以及幼稚T淋巴细胞生成减少。然而，再生过程可发生于儿童，在成人中则很少见，表现为胸腺增生。一名49岁女性患者被诊断为I期乳腺癌。她接受了手术、辅助化疗，随后进行放疗和激素治疗。随访计算机断层扫描显示纵隔胸骨后肿块，引发了对肿瘤复发的担忧。然而，没有其他复发迹象明显。怀疑是胸腺反弹，病变表现为三角形纵隔肿块，提示胸腺形态，由混合脂肪和软组织密度组成，边界光滑。于是决定密切监测。胸部的随访CT扫描显示纵隔肿块消退。随后确诊为化疗后胸腺反弹。该患者目前处于缓解期，自最初诊断乳腺癌已过去七年。化疗后胸腺增生在成人中很少发生。临床医生应意识到这种不寻常的表现，以避免不必要的检查和治疗。
