Weiller P J, Durand J M, Prince-Zucchelli M A, Cros D, Pouget J, Pelissier J F, Mongin M
Ann Med Interne (Paris). 1984;135(4):299-304.
We report the case of a 51 years old woman with myositis, myasthenia gravis and thymoma. First apparent sign is myositis in 1976 but chest X ray show a mediastinal opacity and the patient reports an intermittent diplopia since 1973. The evolution of myositis occurs in two bouts in 1976 and 1981, Myasthenia gravis restricted to diplopia from 1973 to 1979 grow worse first alone then in association with increase of myositis signs in 1981. The mediastinal opacity seen on chest X ray in 1976 don't change and is revealed to be a thymoma at operation in 1981. After thymoma ablation myasthenic and myositis signs decrease. This pathologic association is found 24 times in literature and involves "giant cells" in muscle biopsy in about 50 p. 100 of cases and a myocarditis also with "giant cells". Those "giant cells" unusual in common myositis appears to have a prognostic value.
我们报告了一例患有肌炎、重症肌无力和胸腺瘤的51岁女性病例。最初的明显症状是1976年出现的肌炎，但胸部X光显示纵隔有不透明阴影，且患者自1973年以来就有间歇性复视。肌炎的病情发展在1976年和1981年分两个阶段。1973年至1979年，重症肌无力仅限于复视，起初单独加重，然后在1981年与肌炎症状加重同时出现。1976年胸部X光所见的纵隔不透明阴影没有变化，1981年手术时发现是胸腺瘤。胸腺瘤切除后，重症肌无力和肌炎症状减轻。这种病理关联在文献中被发现24次，在约50%的病例中肌肉活检涉及“巨细胞”，还伴有心肌炎且也有“巨细胞”。这些在普通肌炎中不常见的“巨细胞”似乎具有预后价值。
