Kondo K, Kobayashi T, Urakami T, Kasugai T, Iwata M, Sugino Y, Suzuki Y, Shibata N, Usui M
Department of Respiratory Surgery, Toyota Memorial Hospital, Aichi, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Aug;35(8):900-4.
We encountered three cases of thymic hyperplasia associated with hyperthyroidism. Case 1 was in a 35-year-old woman; a chest CT scan showed an anterior mediastinal mass and right-sided pleural effusion, which suggested the presence of a thymoma Case 2 was in a 21-year-old man who complained of palpebral ptosis and also had myasthenia gravis (Osserman type I). Case 3 was in a 47-year-old woman; a chest CT scan showed thymic hyperplasia and mediastinal lymphadenopathy. In all cases, anti-thyroid medication was given first, because of the associations with hyperthyroidism. Moreover, in cases 1 and 2 no tumor was found, and only hyperplasia was detected in the thymus, although both patients underwent extended thymectomy. Furthermore, surgery was not effective against the hyperthyroidism (anti-thyroid medication could not be withdrawn or reduced). In cases 2 and 3, thymic hyperplasia, as seen on chest CT scans, resolved as thyroid function was normalized by anti-thyroid medication. The pretracheal lymphadenopathy seen in case 3 also resolved. Thymic hyperplasia may have been a result, not a cause, of hyperthyroidism. When we encounter patients with thymic masses and hyperthyroidism, we should give anti-thyroid medication and observe the thymus for some time before resorting to surgery.
我们遇到了3例与甲状腺功能亢进相关的胸腺增生病例。病例1为一名35岁女性；胸部CT扫描显示前纵隔肿块和右侧胸腔积液，提示存在胸腺瘤。病例2为一名21岁男性，主诉睑下垂，同时患有重症肌无力（Osserman I型）。病例3为一名47岁女性；胸部CT扫描显示胸腺增生和纵隔淋巴结肿大。在所有病例中，由于与甲状腺功能亢进相关，首先给予抗甲状腺药物治疗。此外，在病例1和病例2中未发现肿瘤，尽管两名患者均接受了扩大胸腺切除术，但仅在胸腺中检测到增生。此外，手术对甲状腺功能亢进无效（无法停用或减少抗甲状腺药物）。在病例2和病例3中，胸部CT扫描显示的胸腺增生随着抗甲状腺药物使甲状腺功能恢复正常而消退。病例3中所见的气管前淋巴结肿大也消退了。胸腺增生可能是甲状腺功能亢进的结果而非原因。当我们遇到患有胸腺肿块和甲状腺功能亢进的患者时，我们应给予抗甲状腺药物治疗，并在采取手术之前对胸腺观察一段时间。
