Professional Documents
Culture Documents
• Thymoma
Clinical picture: - MG till 50%
- SVC syndrome
Myasthenia gravis and
hyperthyroidism
EMG-D-30%,
positive antiChE test,
CT scan- ? Thymic
Lymphoid Hyperplasia
Treatment:
neostigmine,
steroids
Therapeutic decision
MM, 54-year-old
woman
9-year-history Grave’s
disease
2005 - thyroid profile
TSH-0,1 ui/ml,
fT4 - 1,2ng/ml
CT scan - diffuse goiter
MG and Grave’s disease
2005 MG
EMG-D-18%,
CT- heterogenous normal
sized thymic region
Postoperative outcome-
myasthenic symptoms
controlled with small doses
of neostigmine
Myasthenia gravis and
Hashimoto’s disease
2 cases
Myasthenia gravis+Hashimoto’s, case 1
UD, 54-year-old woman
• 4 years history of progressive MG
• EMG-D-20% , repeat EMG-D-25%
• CT( 2005)- ant-sup. mediastinum with a fibrous - fatty tissues
• Tretment-mestinon 60mg.de 3/zi, PDN-10mg every 2 days, some
improvement
• 2005- Hashimoto’s thyroiditis - ab. antiTPO-556UI/ml, compensated with
75ug/day Euthyrox: TSH-2uUI/ml., Ft4-1,2ng/dl
• Myasthenia gravis got worse with increasing doses of AChE and CS.
• CT 2008 – heterogenous thymic space.
• Thymic scintigraphy - july 2008- discrete hyperfixation of 99mTc
Tetrofosmin, heterogenous, with vertical trajectory in the left paramedian
anterior mediastinum
Outcome
Cushing syndrome
Thymoma+ Cushing sdr.
• G. M. C., 32-year-old woman ,
• Diagnosed- Cushing sdr.- july 2008 (dr. C. Ungureanu)
• C T, 64-year-old woman
• 8 year-history of MG, CT- evident tumour
• op. 2002-thymectomy+pleurectomy
• Pathology report- Invasive thymoma-Masaoka III
• Post-operative radiotherapy 44 Gy,
• Chemotherapy 1 year- CPh+PDN
• 2003- post-radiotherapy transient myxedema
CT, 60 years old, thymoma+MG, Oss.IV, op. 2002,
Lymphocitic thymoma (type I malignant thymoma)-Masaoka
II ( well encapsulated but microscopic capsular invasion),
adhesions to left M. pleura which was resected
Radiotherapy 44 Gy, chemotherapy, 1 year CP+PDN
Pericarditis at 1 year postRxT
Remission of MG 5 years, 2008- AChE
POSTOPERATIVE THYMIC SCINTIGRAPHY
LACK OF RADIOTRACER FIXATION IN THE ANTERIOR MEDIASTINUM
CT aspects-2009
The absence of the tumour recurrence, pericarditis
2009
Inflammatory pericarditis
Conclusions