ro13-9904 and Thymoma

A 28-year-old male was diagnosed with acute pericarditis after presenting with acute chest pain, fever and an abnormality in an electrocardiogram. No symptoms suggestive of myasthenia gravis were observed. Although the symptoms were alleviated by antibiotics, computed tomography (CT) showed an anterior mediastinal mass with bilateral pleural effusion. He was, therefore, diagnosed with thymoma and referred to our hospital. Surgery was performed, since the pleural effusion disappeared. The pathological examination revealed the mass to be a type B2 thymoma classified as pathological stage I (Masaoka's classification) with a multilocular thymic cyst.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Ceftriaxone; Humans; Magnetic Resonance Imaging; Male; Mediastinal Cyst; Mediastinal Neoplasms; Pericarditis; Pleural Effusion; Thymectomy; Thymoma; Tomography, X-Ray Computed; Treatment Outcome

Hypogammaglobulinemia develops in 3 to 6% of patients with thymoma and this association is commonly referred to as thymoma with immunodeficiency (formerly Good syndrome). Recurrent infections with encapsulated bacteria and opportunistic infections associated with disorders of both humoral and cell mediated immunity frequently occur in this rare primary, adult-onset immunodeficiency. We report a case of thymoma with immunodeficiency complicated by disseminated herpes simplex virus (HSV) infection and review five additional cases of HSV-related infections reported since 1966 in patients presenting with thymoma with immunodeficiency. Patients presented with epiglottitis, keratitis, recurrent genital herpes, ulcerative dermatitis, and acute hepatitis. Four of the six cases had a fatal outcome, two of which were directly attributable to HSV infection. Since the risk of invasive opportunistic infections is high and the presentation atypical, lymphocyte count and total serum immunoglobulin should be measured regularly in all patients presenting with thymoma with immunodeficiency.

Topics: Adult; Aged; Ceftriaxone; Fatal Outcome; Female; Herpes Simplex; Humans; Immunoglobulins; Immunologic Deficiency Syndromes; Male; Middle Aged; Thymoma; Thymus Neoplasms