Szobor A, Kas J, Klein M, Rigler A, Rakonczai G, Vincze L
Budapest Fövárosi Onkormányzat Jahn Ferenc Dél-pesti Kórháza Organikus Idegosztály.
Orv Hetil. 1994 Jan 9;135(2):59-65.
Out of 700 patients operated on account of myasthenia gravis, 144 cases with tumours (20.57%) were evaluated. Classification took place in five groups: 1. Thymoma and myasthenia gravis; 2. Thymic cysts and myasthenia gravis; 3. Thymoma and latent myasthenia gravis; 4. Paraneoplastic myasthenia-syndrome; 5. Thymoma, myasthenia gravis and myasthenia-syndrome. Up-to-date classification of thymomas is: epithelioma with minimal, marked or overwhelming lymphatic reaction. Dark-cell and light-cell epitheliomas equally associate with myasthenia. Concerning prognosis, location of the tumour to thymic capsula, surrounding, perithymic tissue is more important than the histologic structure of the tumour. Previous examination in the case of mediastinal tumour can reveal latent, mild myasthenia which was not known till that time. Term of postthymectomic myasthenia can be excluded on the basis of these examinations. Heterogeneity is considerable among myasthenia-syndromes concerning both histopathologic and clinical features. There is a double indication of operation in the case of myasthenia with tumour: the tumour and the disease. Good results can be achieved in myasthenia gravis associated with tumour by means of total operation, post-operative radiation and by other up-to-date therapeutical procedures. The results are hardly beyond those of non-tumours myasthenia gravis.
在700例因重症肌无力接受手术的患者中，对144例伴有肿瘤的病例（20.57%）进行了评估。分类分为五组：1.胸腺瘤与重症肌无力；2.胸腺囊肿与重症肌无力；3.胸腺瘤与隐匿性重症肌无力；4.副肿瘤性肌无力综合征；5.胸腺瘤、重症肌无力与肌无力综合征。胸腺瘤的最新分类为：上皮瘤伴轻微、显著或压倒性淋巴反应。暗细胞和亮细胞上皮瘤均与重症肌无力相关。关于预后，肿瘤位于胸腺包膜、周围及胸腺周围组织的情况比肿瘤的组织结构更重要。纵隔肿瘤病例的先前检查可发现此前未知的隐匿性、轻度重症肌无力。基于这些检查可排除胸腺切除术后肌无力的期限。肌无力综合征在组织病理学和临床特征方面存在相当大的异质性。伴有肿瘤的肌无力病例存在双重手术指征：肿瘤和疾病。通过全手术、术后放疗及其他最新治疗方法，与肿瘤相关的重症肌无力可取得良好效果。其结果与非肿瘤性重症肌无力的结果相比，提升幅度不大。
