Giant idiopathic thymic hyperplasia

İdiyopatik dev timik hiperplazi

Aslı Gül Akgül, Funda Çorapcıoğlu, Salih Topçu, Sema Bay, Şerife Tuba Liman, Serkan Özbay, Seymur Salih Mehmetoğlu, Kürşat Yıldız

¹Departments of Thoracic Surgery, Medical Faculty of Kocaeli University, Kocaeli, Turkey
²Departments of Pediatric Oncology, Medical Faculty of Kocaeli University, Kocaeli, Turkey
³Departments of Pathology, Medical Faculty of Kocaeli University, Kocaeli, Turkey

DOI : 10.5606/tgkdc.dergisi.2015.10227

Thymic hyperplasia may occur in correlation with some diseases or as a rebound phenomenon during recovery from a stressful event such as steroid therapy or chemotherapy for malignant tumors. However, idiopathic true thymic hyperplasia is very rare.[1-3] It can be asymptomatic or can present with symptoms resulting from compression to the lung and airway. Herein, we present the cases of an 11-yearold girl with giant idiopathic thymic hyperplasia that was detected on her radiological examinations (Figures 1a and b) who was also suffering from dyspnea. The mass was subsequently excised via a right thoracotomy (Figure 1c).

Figure 1: (a, b) A radiological view showing the giant idiopathic hyperplasia, (c) a photograph showing the surgical specimen, and (d, e) a microscopic view showing the giant thymic hyperplasia. [(d): H-E x 100; (e) H-E x 200].

On macroscopy, the solid proliferation of the tan-colored loose tissue formed lobular sections, and microscopy revealed the presence of minimal lipoid tissue throughout the lymphoid lobules and epithelial cells at the center of the lymphoid structures. In addition, the scattered, partly calcified Hassall’s corpuscles were remarkable (Figure 1d), and higher magnification showed that the mixture of lymphoid tissue, thymic epithelial components, and Hassall’s corpuscles were consistent with thymic hyperplasia (Figure 1e). Since the basic lobular structure of the thymic tissue persisted, thymoma was ruled out. After performing the thoracotomy, the patient’s postoperative recovery was uneventful.

Declaration of conflicting interests
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding
The authors received no financial support for the research and/or authorship of this article.

References

1) Gow KW, Kobrynski L, Abramowsky C, Lloyd D. Massive benign thymic hyperplasia in a six-month-old girl: case report. Am Surg 2003;69:717-9.

2) Szarf G, de Andrade TC, de Oliveira R, Ota LH, Lederman HM. Massive thymic hyperplasia presenting with respiratory insufficiency in a 2-year-old child. Thorax 2010;65:555-6.

3) Tan Z, Ying LY, Zhang ZW, Li JH, Gao Z, Qi JC. True thymic hyperplasia in an infant. J Pediatr Surg 2010;45:1711-3.

References

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