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2015 ; 10
(ä): 103
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Thymic lymphoid hyperplasia with multilocular thymic cysts diagnosed before the
Sjögren syndrome diagnosis
#MMPMID26173602
Minato H
; Kinoshita E
; Nakada S
; Nojima T
; Tanaka M
; Usuda K
; Sagawa M
; Iwao H
; Tanaka M
; Doai M
; Takahashi T
; Shibata N
Diagn Pathol
2015[Jul]; 10
(ä): 103
PMID26173602
show ga
BACKGROUND: Thymic lymphoid hyperplasia is often present with myasthenia gravis
as well as other autoimmune diseases such as systemic lupus erythematosus and
rheumatoid arthritis. Of the 4 cases of thymic lymphoid hyperplasia associated
with Sjögren syndrome that have been reported, no case with a thymic lesion
diagnosis that led to the diagnosis of Sjögren syndrome has been reported. We
herein report a case of thymic lymphoid hyperplasia with multilocular thymic
cysts, diagnosed before Sjögren syndrome. CASE PRESENTATION: A 37-year-old
Japanese woman had an approximate 5-cm anterior mediastinal mass detected by
chest imaging. The resected lesion revealed multilocular thymic cysts that were
filled with colloid-like material. Histology showed lymph follicular hyperplasia
with many epithelial cysts. The epithelium consisted of thymic medullary
epithelium, and no epithelial proliferation was seen in the lymphoid tissue.
Lymphocytes were composed of an organized mixed population of mature T and B
cells without significant atypia. The infiltrated B cells did not reveal light
chain restriction or immunoglobulin heavy chain gene rearrangement. After the
pathological diagnosis of thymic lesion, tests for the presence of autoantibodies
were positive for antinuclear antibodies, rheumatic factor, and anti-SSA/Ro
antibodies. The Schirmer's, chewing gum, and Saxon tests showed decreased
salivary and lacrimal secretion. Lip biopsy showed focal lymphocytic
sialadenitis. The signs and symptoms of Sjögren syndrome had not resolved,
without aggravation, 1 year after the thymectomy. CONCLUSION: When a case with
thymic lymphoid hyperplasia without myasthenia gravis is encountered, it is
essential to consider the presence of another autoimmune disease including
Sjögren syndrome.