Okumura S, Ohta T, Fujioka M, Nakabayashi H
Department of Thoracic and Cardiovascular Surgery, Mimihara General Hospital, Osaka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Jun;43(6):917-21.
We reported a case of 53-year-old male who was admitted to our hospital for ptosis and difficulty in chewing. Because of positive for Tensilon test and high dose anti-acetylcoline receptor antibody, we established diagnosis for myasthenia gravis. Additionally he was pointed out a cystic lesion at anterior superior mediastinum on CT and MRI. As a result we diagnosed him as thymic cyst with myastenia gravis. The extended thymectomy was performed. Histological examination revealed that the mass was a multilocular thymic cyst which is reported by Suster, who suggested that the multilocular thymic cyst arises from processes of reactions to an acquired inflammatory change. There was no report for cases of multilocular thymic cyst with myastenia gravis. MTC-like changes are sometimes presented in association with thymic Hodgkin's disease or thymic seminoma. Malignant transformation of thymic cyst were also reported. So careful examination and evaluation for cystic lesion within thymus are required.
我们报告了一例53岁男性患者，因上睑下垂和咀嚼困难入院。由于腾喜龙试验阳性及高剂量抗乙酰胆碱受体抗体，我们确诊为重症肌无力。此外，CT和MRI显示其前上纵隔有一个囊性病变。结果，我们诊断他为重症肌无力合并胸腺囊肿。遂行扩大胸腺切除术。组织学检查显示该肿物为多房性胸腺囊肿，正如Suster所报道的那样，他认为多房性胸腺囊肿源于对后天性炎症变化的反应过程。目前尚无多房性胸腺囊肿合并重症肌无力的病例报道。类似MTC的改变有时与胸腺霍奇金病或胸腺精原细胞瘤相关。也有胸腺囊肿恶变的报道。因此，对于胸腺内的囊性病变需要仔细检查和评估。
