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The Spectrum of Diseases Associated With Thymoma: Coincidence or Syndrome?

The Spectrum of Diseases Associated With Thymoma: Coincidence or Syndrome? Abstract Among 598 patients with thymoma (452 found in the literature and 146 from the Mayo Clinic), 422 (71%) suffered from 493 other diseases suspected of being associated with thymoma; 423 of these cases involved disorders of immunity. In contrast, there were only 21 patients (12%) each with one case of these other diseases among 177 Mayo Clinic patients with parathyroid adenoma; 19 of these involved immunity disorders. The total of 423 cases of diseases related to disorders of immunity included, among others, myasthenia gravis (44%), cytopenias (21%), cancer (17%), hypogammaglobulinemia (6%), polymyositis (5%), and systemic lupus erythematosus (2%). These findings merit consideration of thymoma together with certain diseases as a syndrome rather than as a spectrum of coincidental diseases. References 1. Good RA: Agammaglobulinemia: A provocative experiment of nature. Bull Univ Minn Hosp Minn Med Found 26:1-19, 1954. 2. Castleman B: Tumors of the thymus gland , in Atlas of Tumor Pathology , fascicle 19. Washington DC, Armed Forces Institute of Pathology, 1955. 3. Clagett OT, Eaton LM: Thymic tumors in myasthenia gravis. Surg Clin North Am 23:1076-1082, 1943. 4. Rogers BHG, Manaligod JR, Blazek WV: Thymoma associated with pancytopenia and hypogammaglobulinemia: Report of a case and review of the literature. Am J Med 44:154-164, 1968.Crossref 5. Souadjian JV, Silverstein MN, Titus JL: Thymoma and cancer. Cancer 22:1221-1225, 1968.Crossref 6. Hirst E, Robertson TI: The syndrome of thymoma and erythroblastopenic anemia: A review of 56 cases including three case reports. Medicine 46:225-264, 1967.Crossref 7. Strauss AJL, et al: Immunofluorescence demonstration of a muscle binding, complement-fixing serum globulin fraction in myasthenia gravis. Proc Soc Exp Biol Med 105:184-191, 1960.Crossref 8. White RG, Marshall AHE: The autoimmune response in myasthenia gravis. Lancet 2:120-123,1962.Crossref 9. Oosterhuis HJGH: Studies in myasthenia gravis: I. A clinical study of 180 patients. J Neurol Sci 1:512-546, 1964.Crossref 10. Barnes RD: Thymic neoplasms associated with refractory anaemia. Guys Hosp Rep 114:73-82, 1965. 11. Jacobs EM, et al: Benign thymoma and selective erythroid aplasia of the bone marrow. Cancer 12:47-57, 1959.Crossref 12. Jepson JH, Lowenstein L: Inhibition of erythropoiesis by a factor present in the plasma of patients with erythroblastopenia. Blood 27:425-434, 1966. 13. Schwartz M: Intrinsic factor antibody in serum from patients with pernicious anaemia. Lancet 2:1263-1267, 1960.Crossref 14. Irvine WJ, et al: Immunological relationship between pernicious anaemia and thyroid disease. Br Med J 2:454-456, 1962.Crossref 15. Doniach D, Roitt IM, Taylor KB: Autoimmune phenomena in pernicious anaemia: Serological overlap with thyroiditis, thyrotoxicosis, and systemic lupus erythematosus. Br Med J 1:1374-1379, 1963.Crossref 16. Christian CL: Rheumatoid arthritis , in Samter M (ed): Immunological Diseases , ed 2. Boston, Little Brown & Co, 1971, vol 2, pp 1014-1028. 17. Page AR, Hansen AE, Good RA: Occurrence of leukemia and lymphoma in patients with agammaglobulinemia. Blood 21:197-206, 1963. 18. Fudenberg H, German JL III, Kunkel HG: The occurrence of rheumatoid factor and other abnormalities in families of patients with agammaglobulinemia. Arthritis Rheum 5:565-588, 1962.Crossref 19. Klein JJ, et al: Thymoma and polymyositis: Onset of myasthenia gravis after thymectomy; report of two cases. Arch Intern Med 113:142-152, 1964.Crossref 20. Souadjian JV, Howell LP, Lambert EH: Thymoma with myopathy: Report of a case. Minn Med 52:595-596, 1969. 21. Rowland LP, Hoefer PFA, Aronow H Jr: Myasthenic syndromes. Assoc Res Nerv Ment Dis 38:548-600, 1960. 22. Holman HR: Systemic lupus erythematosus , in Samter M (ed): Immunological Diseases , ed 2. Boston, Little Brown & Co, 1971, vol 2, pp 995-1013. 23. Bloch KJ, et al: Sjögren's syndrome: A clinical, pathological, and serological study of 62 cases. Medicine 44:187-231, 1965.Crossref 24. Rothfield NF, Rodnan GP: Serum antinuclear antibodies in progressive systemic sclerosis (scleroderma). Arthritis Rheum 11:607-617, 1968.Crossref 25. Weigle WO, et al: Autoimmunity and termination of immunological unresponsiveness. Arch Pathol 84:647-658, 1967. 26. Southam CM: Cancer-specific antigens in man , in Samter M (ed): Immunological Diseases , ed 2. Boston, Little Brown & Co, 1971, vol 1, pp 743-764. 27. Southam CM: The immunologic status of patients with nonlymphomatous cancer. Cancer Res 28:1433-1440, 1968. 28. Metcalf D: The thymus: Its role in immune responses, leukaemia development and carcinogenesis. Recent Results Cancer Res 5:1-144, 1966. 29. Souadjian JV, Silverstein MN, Titus JL: Morphologic studies of the thymus in human neoplasia. Cancer 23:619-625, 1969.Crossref 30. Dore JF, et al: New antigens in human leukaemic cells, and antibody in the serum of leukaemic patients. Lancet 2:1396-1398, 1967.Crossref 31. Williams RC Jr: Dermatomyositis and malignancy: A review of the literature. Ann Intern Med 50:1174-1181, 1959.Crossref 32. Good RA, et al: The role of the thymus in immune process. Ann NY Acad Sci 135:451-478, 1966.Crossref 33. Burnet M: Role of the thymus and related organs in immunity. Br Med J 2:807-811, 1962.Crossref 34. Allison AC, Denman AM, Barnes RD: Cooperating and controlling functions of thymus-derived lymphocytes in relation to autoimmunity. Lancet 2:135-140, 1971.Crossref 35. Pirofsky B: Autoimmune hemolytic anemia and neoplasia of the reticuloendothelium: With a hypothesis concerning etiologic relationships. Ann Intern Med 68:109-121, 1968.Crossref 36. Failkow PJ, Fudenberg H, Epstein WV: "Acquired" antibody hemolytic anemia and familial aberrations in gamma globulins. Am J Med 36:188-199, 1964.Crossref 37. Cordova MS, et al: Acquired hemolytic anemia with positive autoglobulin (Coombs' test) in mother and daughter. Arch Intern Med 117:692-695, 1966.Crossref 38. Dobbs CE: Familial auto-immune hemolytic anemia. Arch Intern Med 116:273-276, 1965.Crossref 39. Burnet M: Immunological factors in the process of carcinogenesis. Br Med Bull 20:154-158,1964. 40. Miller DG: The association of immune disease and malignant lymphoma. Ann Intern Med 66:507-521, 1967.Crossref 41. Good RA, et al: Immunological deficiency diseases: Agammaglobulinemia, hypogammaglobulinemia, Hodgkin's disease and sarcoidosis. Prog Allergy 6:187-319, 1962. 42. Milne JA, et al: Thymectomy in acute systemic lupus erythematosus and rheumatoid arthritis. Br Med J 1:461-464, 1967.Crossref 43. Burnet FM: Autoimmune disease , in Sodeman WA, Sodeman WA Jr (eds): Pathologic Physiology: Mechanisms of Disease , ed 4. Philadelphia, WB Saunders Co, 1967, pp 15-33. 44. Lattes R: Thymoma and other tumors of the thymus: An analysis of 107 cases. Cancer 15:1224-1260, 1962.Crossref 45. Castleman B, Norris EH: The pathology of the thymus in myasthenia gravis: A study of 35 cases. Medicine 28:27-58, 1949.Crossref 46. Goldstein G: Thymitis and myasthenia gravis. Lancet 2:1164-1167, 1966.Crossref 47. Goldstein G, Mackay IR: Contrasting abnormalities in the thymus in systemic lupus erythematosus and myasthenia gravis: A quantitative histological study. Aust J Exp Biol Med Sci 43:381-390, 1965.Crossref 48. Gabrielsen AE, Good RA: Thymoma. Ann Intern Med 65:607-611, 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Spectrum of Diseases Associated With Thymoma: Coincidence or Syndrome?

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Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1974.00320200184029
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Abstract

Abstract Among 598 patients with thymoma (452 found in the literature and 146 from the Mayo Clinic), 422 (71%) suffered from 493 other diseases suspected of being associated with thymoma; 423 of these cases involved disorders of immunity. In contrast, there were only 21 patients (12%) each with one case of these other diseases among 177 Mayo Clinic patients with parathyroid adenoma; 19 of these involved immunity disorders. The total of 423 cases of diseases related to disorders of immunity included, among others, myasthenia gravis (44%), cytopenias (21%), cancer (17%), hypogammaglobulinemia (6%), polymyositis (5%), and systemic lupus erythematosus (2%). These findings merit consideration of thymoma together with certain diseases as a syndrome rather than as a spectrum of coincidental diseases. References 1. Good RA: Agammaglobulinemia: A provocative experiment of nature. Bull Univ Minn Hosp Minn Med Found 26:1-19, 1954. 2. Castleman B: Tumors of the thymus gland , in Atlas of Tumor Pathology , fascicle 19. Washington DC, Armed Forces Institute of Pathology, 1955. 3. Clagett OT, Eaton LM: Thymic tumors in myasthenia gravis. Surg Clin North Am 23:1076-1082, 1943. 4. Rogers BHG, Manaligod JR, Blazek WV: Thymoma associated with pancytopenia and hypogammaglobulinemia: Report of a case and review of the literature. Am J Med 44:154-164, 1968.Crossref 5. Souadjian JV, Silverstein MN, Titus JL: Thymoma and cancer. Cancer 22:1221-1225, 1968.Crossref 6. Hirst E, Robertson TI: The syndrome of thymoma and erythroblastopenic anemia: A review of 56 cases including three case reports. Medicine 46:225-264, 1967.Crossref 7. Strauss AJL, et al: Immunofluorescence demonstration of a muscle binding, complement-fixing serum globulin fraction in myasthenia gravis. Proc Soc Exp Biol Med 105:184-191, 1960.Crossref 8. White RG, Marshall AHE: The autoimmune response in myasthenia gravis. Lancet 2:120-123,1962.Crossref 9. Oosterhuis HJGH: Studies in myasthenia gravis: I. A clinical study of 180 patients. J Neurol Sci 1:512-546, 1964.Crossref 10. Barnes RD: Thymic neoplasms associated with refractory anaemia. Guys Hosp Rep 114:73-82, 1965. 11. Jacobs EM, et al: Benign thymoma and selective erythroid aplasia of the bone marrow. Cancer 12:47-57, 1959.Crossref 12. Jepson JH, Lowenstein L: Inhibition of erythropoiesis by a factor present in the plasma of patients with erythroblastopenia. Blood 27:425-434, 1966. 13. Schwartz M: Intrinsic factor antibody in serum from patients with pernicious anaemia. Lancet 2:1263-1267, 1960.Crossref 14. Irvine WJ, et al: Immunological relationship between pernicious anaemia and thyroid disease. Br Med J 2:454-456, 1962.Crossref 15. Doniach D, Roitt IM, Taylor KB: Autoimmune phenomena in pernicious anaemia: Serological overlap with thyroiditis, thyrotoxicosis, and systemic lupus erythematosus. Br Med J 1:1374-1379, 1963.Crossref 16. Christian CL: Rheumatoid arthritis , in Samter M (ed): Immunological Diseases , ed 2. Boston, Little Brown & Co, 1971, vol 2, pp 1014-1028. 17. Page AR, Hansen AE, Good RA: Occurrence of leukemia and lymphoma in patients with agammaglobulinemia. Blood 21:197-206, 1963. 18. Fudenberg H, German JL III, Kunkel HG: The occurrence of rheumatoid factor and other abnormalities in families of patients with agammaglobulinemia. Arthritis Rheum 5:565-588, 1962.Crossref 19. Klein JJ, et al: Thymoma and polymyositis: Onset of myasthenia gravis after thymectomy; report of two cases. Arch Intern Med 113:142-152, 1964.Crossref 20. Souadjian JV, Howell LP, Lambert EH: Thymoma with myopathy: Report of a case. Minn Med 52:595-596, 1969. 21. Rowland LP, Hoefer PFA, Aronow H Jr: Myasthenic syndromes. Assoc Res Nerv Ment Dis 38:548-600, 1960. 22. Holman HR: Systemic lupus erythematosus , in Samter M (ed): Immunological Diseases , ed 2. Boston, Little Brown & Co, 1971, vol 2, pp 995-1013. 23. Bloch KJ, et al: Sjögren's syndrome: A clinical, pathological, and serological study of 62 cases. Medicine 44:187-231, 1965.Crossref 24. Rothfield NF, Rodnan GP: Serum antinuclear antibodies in progressive systemic sclerosis (scleroderma). Arthritis Rheum 11:607-617, 1968.Crossref 25. Weigle WO, et al: Autoimmunity and termination of immunological unresponsiveness. Arch Pathol 84:647-658, 1967. 26. Southam CM: Cancer-specific antigens in man , in Samter M (ed): Immunological Diseases , ed 2. Boston, Little Brown & Co, 1971, vol 1, pp 743-764. 27. Southam CM: The immunologic status of patients with nonlymphomatous cancer. Cancer Res 28:1433-1440, 1968. 28. Metcalf D: The thymus: Its role in immune responses, leukaemia development and carcinogenesis. Recent Results Cancer Res 5:1-144, 1966. 29. Souadjian JV, Silverstein MN, Titus JL: Morphologic studies of the thymus in human neoplasia. Cancer 23:619-625, 1969.Crossref 30. Dore JF, et al: New antigens in human leukaemic cells, and antibody in the serum of leukaemic patients. Lancet 2:1396-1398, 1967.Crossref 31. Williams RC Jr: Dermatomyositis and malignancy: A review of the literature. Ann Intern Med 50:1174-1181, 1959.Crossref 32. Good RA, et al: The role of the thymus in immune process. Ann NY Acad Sci 135:451-478, 1966.Crossref 33. Burnet M: Role of the thymus and related organs in immunity. Br Med J 2:807-811, 1962.Crossref 34. Allison AC, Denman AM, Barnes RD: Cooperating and controlling functions of thymus-derived lymphocytes in relation to autoimmunity. Lancet 2:135-140, 1971.Crossref 35. Pirofsky B: Autoimmune hemolytic anemia and neoplasia of the reticuloendothelium: With a hypothesis concerning etiologic relationships. Ann Intern Med 68:109-121, 1968.Crossref 36. Failkow PJ, Fudenberg H, Epstein WV: "Acquired" antibody hemolytic anemia and familial aberrations in gamma globulins. Am J Med 36:188-199, 1964.Crossref 37. Cordova MS, et al: Acquired hemolytic anemia with positive autoglobulin (Coombs' test) in mother and daughter. Arch Intern Med 117:692-695, 1966.Crossref 38. Dobbs CE: Familial auto-immune hemolytic anemia. Arch Intern Med 116:273-276, 1965.Crossref 39. Burnet M: Immunological factors in the process of carcinogenesis. Br Med Bull 20:154-158,1964. 40. Miller DG: The association of immune disease and malignant lymphoma. Ann Intern Med 66:507-521, 1967.Crossref 41. Good RA, et al: Immunological deficiency diseases: Agammaglobulinemia, hypogammaglobulinemia, Hodgkin's disease and sarcoidosis. Prog Allergy 6:187-319, 1962. 42. Milne JA, et al: Thymectomy in acute systemic lupus erythematosus and rheumatoid arthritis. Br Med J 1:461-464, 1967.Crossref 43. Burnet FM: Autoimmune disease , in Sodeman WA, Sodeman WA Jr (eds): Pathologic Physiology: Mechanisms of Disease , ed 4. Philadelphia, WB Saunders Co, 1967, pp 15-33. 44. Lattes R: Thymoma and other tumors of the thymus: An analysis of 107 cases. Cancer 15:1224-1260, 1962.Crossref 45. Castleman B, Norris EH: The pathology of the thymus in myasthenia gravis: A study of 35 cases. Medicine 28:27-58, 1949.Crossref 46. Goldstein G: Thymitis and myasthenia gravis. Lancet 2:1164-1167, 1966.Crossref 47. Goldstein G, Mackay IR: Contrasting abnormalities in the thymus in systemic lupus erythematosus and myasthenia gravis: A quantitative histological study. Aust J Exp Biol Med Sci 43:381-390, 1965.Crossref 48. Gabrielsen AE, Good RA: Thymoma. Ann Intern Med 65:607-611, 1966.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1974

References