In medicine (oncology), thymoma is a neoplasm of the thymus. It is a rare disease, best known for its enigmatic association with the neuromuscular disorder myasthenia gravis. There are benign and malignant forms, which present similarly. NLM (National Library of Medicine, contains resources for patients and healthcare professionals) Virtual Hospital (digital health sciences library by the University of Iowa) Online Medical Dictionary Collection of links to free medical resources Wikicities has a wiki about medicine: Medicine Categories: Medicine | Health ... Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases. ... Neoplasia (literally: new growth) is sudden and abnormal growth in a tissue or organ. ... Thymus, see Thyme. ... A rare disease has such a low prevalence in a population that a doctor in a busy general practice would not expect to see more than one case a year. ... Myasthenia gravis (MG, Latin: grave muscle weakness) is a neuromuscular disease leading to fluctuating weakness and fatiguability. ...

Signs and symptoms

• 33%-50% is detected accidentally on routine X-rays of the chest.
• 33% presents with complaints due to compression of surrounding structures by the expanding tumor:
  • Vena cava superior syndrome (compression of the upper caval vein)
  • Dysphagia (trouble swallowing)
  • Cough, chest pain
• A final 33% has autoimmune symptoms; thymomas in these are usually benign. The best known is myasthenia gravis, of which 25-50% is associated with a thymoma. Some others are: pure red cell aplasia and Good's syndrome (thymoma with combined immunodeficiency and hypoimmunoglobulinemia G).
  • Rare associations that have been reported are: acute pericarditis, Addison's disease, agranulocytosis, alopecia areata, ulcerative colitis, Cushing's disease, hemolytic anemia, limbic encephalopathy, myocarditis, nephrotic syndrome, panhypopituitarism, pernicious anemia, polymyositis, rheumatoid arthritis, sarcoidosis, scleroderma, sensorimotor radiculopathy, stiff person syndrome, systemic lupus erythematosus and thyreoiditis.

Malignant thymomas can metastasize, generally to pleura, kidney, bone, liver or brain. In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... The superior vena cava (also known as the anterior vena cava) is formed by the union of the left and right brachiocephalic veins (the innominate veins) and terminates in the right atrium of the heart. ... Dysphagia is the technical term for the symptom of the sensation of difficulty in swallowing. ... In medicine, chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). // Causes Cardiopulmonary Important cardiovascular and... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Myasthenia gravis (MG, Latin: grave muscle weakness) is a neuromuscular disease leading to fluctuating weakness and fatiguability. ... Addisons disease (also known as chronic adrenal insufficiency, or hypocortisolism) is a rare endocrine disorder. ... Cushings syndrome or hypercortisolism is an endocrine disorder caused by excessive levels of the endogenous corticosteroid hormone cortisol. ... Hemolysis (alternative spelling haemolysis) is the excessive breakdown of red blood cells. ... In medicine (cardiology), myocarditis is inflammation of the myocardium, the muscular part of the heart. ... Hypopituitarism is a medical term describing deficiency (hypo) of one or more hormones of the pituitary gland. ... Pernicious anemia refers to a type of autoimmune anemia. ... Polymyositis A type of Inflammatory Myopathy, related to Dermatomyositis and Inclusion body myositis. ... Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... Scleroderma is a rare, chronic disease characterized by excessive deposits of collagen. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ... In anatomy, the pleural cavity is the potential space between the lungs and the chest wall. ... Kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ... Grays illustration of a human femur, a typically recognized bone. ... The liver is an organ in vertebrates, including humans. ... In the anatomy of animals, the brain, or encephalon, is the supervisory center of the nervous system. ...

Diagnosis

When a thymic pass is identified, the diagnosis is achieved with histology (obtaining a tissue sample of the mass). When a thymoma is suspected, a CT/CAT scan is generally performed to estimate the size of the tumor, and can be biopsied with a CT-guided needle. Although there is a risk of pneumomediastinum, mediastinitis and the risk of damaging the heart or large blood vessels. Histology is the study of tissue sectioned as a thin slice, using a microscope. ... CT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Pneumomediastinum means there is air in the mediastinum ... The heart (Latin cor) is a hollow, muscular organ that pumps blood through the blood vessels by repeated, rhythmic contractions. ...

The tumor is generally located inside the thymus, and can be calcified. Increased vascular enhancement can be indicative of malignancy, as can be pleural deposits.

If the suspicion is real, some blood tests are often performed to gain an appreciation of associated problems or possible spread. These include: full blood count, protein electrophoresis, antibodies to the acetylcholine receptor (indicative of myasthenia), electrolytes, liver enzymes and renal function. Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... A full blood count (FBC) or complete blood count (CBC) is a test requested by a doctor or other medical professional that gives information about the cells in a patients blood. ... Please see gel electrophoresis for the principles of electrophoresis Schematic representation of a protein electrophoresis gel In chemistry and medicine, protein electrophoresis is a method of analysing a mixture of proteins by means of gel electrophoresis, mainly in blood serum (blood plasma is not suitable). ... Wikipedia does not yet have an article with this exact name. ... An acetylcholine receptor (abbreviated AChR) is an integral membrane protein that responds to the binding of the neurotransmitter acetylcholine by opening a pathway in the membrane for the diffusion of ions across the cell membrane. ... An electrolyte is a substance which dissociates free ions when dissolved (or molten), to produce an electrically conductive medium. ... Liver function tests (LFTs or LFs), are groups of clinical biochemistry laboratory blood assays designed to give a doctor or other health professional information about the state of a patients liver. ... In medicine (nephrology) renal function is an indication of the state of the kidney and its role in physiology. ...

The final diagnosis is made by removing the thymus. Pathological investigation of the specimen will reveal if the tumor was benign or malignant. Anatomical pathology is the branch of pathology that is concerned with the diagnosis of disease based on the gross and microscopic examination of cells and tissues. ...

Pathophysiology

Thymomas originate from the epithelial cell population in the thymus. Many subtypes are recognised, some of which have a better- or worse-than-general prognosis. In zootomy, epithelium is a tissue composed of a layer of cells. ...

Epidemiology

Men and women are equally affected. The main age for thymomas is 30-40, although cases have been described in every age group.

Treatment

Surgery is the mainstay of treatment. If the tumor was benign and was removed in its entirety, no further therapy is necessary. Malignant tumors may need additional treatment with radiotherapy, or sometimes with chemotherapy. Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...

If surgery is not feasible, due to invasion of surrounding tissues by the tumor, then chemotherapy using cyclophosphamide, doxorubicin and cisplatin is used to shrink the tumor. This is followed by surgery if possible and radiation. Cyclophosphamide is a nitrogen mustard alkylating agent, used to treat various types of cancer and some autoimmune disorders. ... Doxorubicin is a pharmaceutical drug widely used in cancer chemotherapy. ... Cisplatin or cis-diaminedichloroplatinum(II) (CDDP) is a platinum-based chemotherapy drug used to treat various types of cancers, including sarcomas, some carcinomas (e. ...

Removal of the thymus in adults does not appear to induce a severe immune deficiency. In children, however, added care and scrupulous vaccination are necessary to protect from infections. In medicine, immune deficiency (or immunodeficiency) is a state where the immune system is incapable of defending the organism from infectious disease. ...

Source

• Thomas CR, Wright CD, Loehrer PJ. Thymoma: state of the art. J Clin Oncol 1999;17:2280-9. PMID 10561285.

External link

• A large resource about thymoma