Palestro G, Tridente G, Botto Micca F, Novero D, Valente G, Godio L
Virchows Arch B Cell Pathol Incl Mol Pathol. 1983;44(2):173-86. doi: 10.1007/BF02890168.
Normal fetal and postnatal thymuses, as well as thymuses from patients with myasthenia gravis (MG), were investigated by immunohistochemical and enzyme histochemical techniques and their morphology reviewed. Intrathymic B-cells, detected by ATPase activity, were found to be markedly increased in number in MG thymuses. They were scattered in the medulla and accumulated around the junctional and medullary vessels and Hassall's corpuscles (HCs). Large epithelial cells, singly or within HCs, were found to be unevenly distributed in the medulla of all the thymuses examined. The striated muscle-like nature of some of these cells was revealed by the presence of myoglobin in their cytoplasm. In myasthenics these cells and small developing HCs characteristically surrounded lymph follicles and were in direct contact with the expanded cap of the follicle mantle, without interposition of reticulin fibres. The close association of immune reactive foci (lymphoid follicles, junctional and medullary vessels, and HCs) with structures involved in autoimmune responses in the thymus (muscle-like and true myoid cells, HCs) strongly suggests that the autoimmune reactions against AChR (acetylcholine receptor) and other muscular components, which constitute the basic defects in myasthenia gravis, may begin in the thymus.
通过免疫组织化学和酶组织化学技术对正常胎儿和产后胸腺以及重症肌无力（MG）患者的胸腺进行了研究，并对其形态进行了回顾。通过ATP酶活性检测到的胸腺内B细胞在MG胸腺中的数量明显增加。它们散在于髓质中，并聚集在交界血管、髓质血管和哈氏小体（HCs）周围。在所有检查的胸腺髓质中，发现大的上皮细胞单独或在HCs内分布不均匀。这些细胞中的一些细胞的细胞质中存在肌红蛋白，揭示了它们类似横纹肌的性质。在重症肌无力患者中，这些细胞和发育中的小HCs典型地围绕着淋巴滤泡，并与滤泡套的扩大帽直接接触，中间没有网状纤维。免疫反应灶（淋巴滤泡、交界血管和髓质血管以及HCs）与胸腺中参与自身免疫反应的结构（肌样细胞和真正的肌样细胞、HCs）密切相关，这强烈表明针对乙酰胆碱受体（AChR）和其他肌肉成分的自身免疫反应，构成了重症肌无力的基本缺陷，可能始于胸腺。
