Severe aplastic anemia associated with thymic carcinoma and partial recovery of hematopoiesis after thymectomy
Tóm tắt
Aplastic anemia has been a rare complication of thymic tumors documented in only a few cases. We now report that a previously healthy, 72-year-old woman had a well-differentiated squamous cell thymic carcinoma and severe aplastic anemia, as detected on a simultaneous basis. After extirpation of the thymic carcinoma, hematological recovery was achieved. While cyclosporine (CyA), prednisolone (PSL), and methenolone improved hematological data even more, a partial and stable remission has been sustained for 22 months. The patient's serum prior to the surgery had a suppressive effect on the formation of colonies of erythroid and nonerythroid colonies, as determined using the patient's bone marrow cells and compared with the patient's serum after the surgery and normal AB serum. This case report concerns a patient in whom we observed simultaneous occurrence of a thymic tumor and a sever marrow aplasia for which we describe our therapeutic approach.
Tài liệu tham khảo
Broxmeyer HE, Williams DE, Lu L, Cooper S, Anderson SL, Beyer GS, Hoffman R, Rubin BY (1986) The suppressive influences of human tumor necrosis factors on bone marrow hematopoietic progenitor cells from normal donors and patients with leukemia: synergism of tumor necrosis factor and interferon-gamma. J Immunol 136:4487–4495
Coplu L, Selcuk ZT, Haznedaroglu IC, Dogan R, Gungen Y (2000) Aplastic pancytopenia associated with thymoma. Ann Hematol 79:648–650
Dincol G, Saka B, Aktan M, Nalcaci M, Keskin H, Palanduz S, Ozturk S, Dincol K (2000) Very severe aplastic anemia following resection of lymphocytic thymoma: effectiveness of antilymphocyte globulin, cyclosporin A, and granulocyte-colony stimulating factor. Am J Hematol 64:78–79
Fujimura S, Kondo T, Yamauchi A, Handa M, Nakada T (1985) Experience with surgery for thymoma associated pure red blood cell aplasia. Chest 88:221–225
Handa SI, Schofield KP, Sivakumaran M, Short M, Pumphrey RS (1994) Pure red cell aplasia associated with malignant thymoma, myasthenia gravis, polyclonal large granular lymphocytosis and clonal thymic T cell expansion. J Clin Pathol 47:676–679
Hirst E, Robertson TI (1967) The syndrome of thymoma and erythroblastopenic anemia. A review of 56 cases including 3 case reports. Medicine (Baltimore) 46:225–264
Hofmann W, Moller P, Manke HG, Otto HF (1985) Thymoma. A clinicopathologic study of 98 cases with special reference to three unusual cases. Pathol Res Pract 179:337–353
Kindler V, Thorens B, de Kossodo S, Allet B, Eliason JF, Thatcher D, Farber N, Vassalli P (1986) Stimulation of hematopoiesis in vivo by recombinant bacterial murine interleukin 3. Proc Natl Acad Sci U S A 83:1001–1005
Kobayashi H, Kitano K, Ishida F, Saito H, Miyabayashi H, Yonezawa T, Inada H, Suzuki A, Furuta S (1993) Aplastic anemia and idiopathic thrombocytopenic purpura with antibody to platelet glycoprotein IIb/IIIa following resection of malignant thymoma. Acta Haematol 90:42–45
Levasseur P, Menestrier M, Gaud C, Dartevelle P, Julia P, Rojas-Miranda A, Navajas M, Le Brigand H, Merlier M (1988) Thymomas and associated diseases. Apropos of a series of 255 surgically treated thymomas. Rev Mal Respir 5:173–178
Liozon E, Touati M, Allegraud A, Gachard N, Loustaud V, Vidal E, Bordessoule D (1998) Thymoma-associated pancytopenia: effectiveness of cyclosporine A. Ann Hematol 77:175-178
Lyonnais J (1998) Thymoma and pancytopenia. Am J Hematol 28:195–196
Mangan KF, Volkin R, Winkelstein A (1986) Autoreactive erythroid progenitor-T suppressor cells in the pure red cell aplasia associated with thymoma and panhypogammaglobulinemia. Am J Hematol 23:167–173
Masaoka A, Hashimoto T, Shibata K, Yamakawa Y, Nakamae K, Iizuka M (1989) Thymomas associated with pure red cell aplasia. Histologic and follow-up studies. Cancer 64:1872-1878
Maung ZT, Norden J, Middleton PG, Jack FR, Chandler JE (1994) Pure red cell aplasia: further evidence of T cell clonal disorder. Br J Haematol 87:189-192
Milnes JP, Goorney BP, Wallington TB (1984) Pure red cell aplasia and thymoma associated with high levels of the suppressor/cytotoxic T lymphocyte subset. Br Med J (Clin Res Ed) 289:1333–1334
Rogers BH, Manligod JR, Blazek W (1968) Thymoma associated with pancytopenia and hypogammaglobulinemia. Report of a case and review of the literature. Am J Med 44:154–164
Salyer WR, Eggleston JC (1976) Thymoma: a clinical and pathological study of 65 cases. Cancer 37:229–249
Sawada K, Sato N, Notoya A, Tarumi T, Hirayama S, Takano H, Koizumi K, Yasukouchi T, Yamaguchi M, Koike T (1995) Proliferation and differentiation of myelodysplastic CD34+ cells: phenotypic subpopulations of marrow CD34+ cells. Blood 85:194–202
Soler J, Estivill X, Ayats R, Brunet S, Pujol-Moix N (1985) Chronic T-cell lymphocytosis associated with pure red call aplasia, thymoma and hypogammaglobulinemia. Br J Haematol 61:582–584
Suda T, Suda J, Ogawa M, Ihle JN (1985) Permissive role of interleukin 3 (IL-3) in proliferation and differentiation of multipotential hemopoietic progenitors in culture. J Cell Physiol 124:182–190
Thomas CV, Manivel JC (1987) Thymic carcinoma and aplastic anemia: report of a previously undocumented association. Am J Hematol 25:333–335