Levy Y, Afek A, Sherer Y, Bar-Dayan Y, Shibi R, Kopolovic J, Shoenfeld Y
Department of Medicine B, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Semin Arthritis Rheum. 1998 Oct;28(2):73-9. doi: 10.1016/s0049-0172(98)80039-5.
To determine whether malignant thymoma is associated with high rates of concomitantly occurring autoimmune diseases.
Sheba Medical Center computer records from 1966 to 1995 were reviewed to identify patients with malignant thymoma, either type I (invasive thymoma) or type II (thymic carcinoma). All patients who had malignant thymoma and autoimmune phenomena were analyzed. The diagnosis of thymic neoplasm was confirmed by two independent pathologists. The diagnosis of autoimmune diseases was based on both clinical and serological findings.
Six of 22 (27%) cases of malignant thymoma had an autoimmune disease. Five patients had type I malignant thymoma and either myasthenia gravis (four patients) or Graves' disease (one patient). Only one patient had type II malignant thymoma with Sjögren's syndrome. The diagnosis of autoimmune disease preceded the diagnosis of thymic neoplasm in four cases, and was diagnosed simultaneously in two.
Malignant thymomas are highly associated with autoimmune diseases, as are benign thymomas. To our knowledge, we report the first documented cases of a patient with thymic carcinoma and Sjögren's syndrome, and another with invasive thymoma and Graves' disease.
确定恶性胸腺瘤是否与自身免疫性疾病的高并发率相关。
回顾了1966年至1995年Sheba医疗中心的计算机记录，以识别患有I型（侵袭性胸腺瘤）或II型（胸腺癌）恶性胸腺瘤的患者。对所有患有恶性胸腺瘤和自身免疫现象的患者进行了分析。胸腺肿瘤的诊断由两名独立的病理学家确认。自身免疫性疾病的诊断基于临床和血清学检查结果。
22例恶性胸腺瘤患者中有6例（27%）患有自身免疫性疾病。5例患者患有I型恶性胸腺瘤，其中4例患有重症肌无力，1例患有格雷夫斯病。只有1例II型恶性胸腺瘤患者患有干燥综合征。4例自身免疫性疾病的诊断先于胸腺肿瘤的诊断，2例同时诊断。
与良性胸腺瘤一样，恶性胸腺瘤与自身免疫性疾病高度相关。据我们所知，我们报告了首例有记录的胸腺癌合并干燥综合征以及侵袭性胸腺瘤合并格雷夫斯病的病例。
