Tuberc Respir Dis.  2007 Jan;62(1):67-70. 10.4046/trd.2007.62.1.67.

A Case of Concurrent Thymic Carcinoma with Systemic Lupus Erythematosus

• Lee YJ
• Choi ST
• Kim SH
• Jung KS
• Yoon SH
• Jeung SJ
• Yi SW
• Kim JH

• KMID: 1518492
• DOI: http://doi.org/10.4046/trd.2007.62.1.67

Abstract

A thymic carcinoma is a rare malignant neoplasm of the thymus epithelium, which can be distinguished from a benign or invasive thymoma. Contrary to a thymoma, the association of a thymic carcinoma and autoimmune disease is rare, with only a few cases having been reported. Herein, a case of thymic carcinoma diagnosed concurrently with systemic lupus erythematosus (SLE) is reported. A 49 year-old man presented at our clinic with myalgia. He was diagnosed with SLE, based on an oral ulcer, lymphopenia, and positive ANA and anti-Sm antibodies. Incidentally, a routine chest X-ray showed a large mediastinal mass. Pathological examination of the mediastinal mass revealed an undifferentiated thymic carcinoma, of WHO classification type C. Further work-up for staging showed multiple bone and lung metastases. With a palliative aim, he received systemic chemotherapy, but refused further chemotherapy after the 2nd course. Currently, the patient has not been followed up since the chemotherapy.

Keyword

Thymic carcinoma; Systemic lupus erythematosus; Autoimmune disease

MeSH Terms

Antibodies
Autoimmune Diseases
Classification
Drug Therapy
Epithelium
Humans
Lung
Lupus Erythematosus, Systemic*
Lymphopenia
Middle Aged
Myalgia
Neoplasm Metastasis
Oral Ulcer
Thorax
Thymoma*
Thymus Gland
Antibodies

Figure

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  Figure 1 Positron emission tomography revealed the strong FDG uptake on a large irregular mass in anterior mediastinum, multiple lung nodules with bilateral lymphadenopathy, the 8th T-spine, right iliac crest, and the posterior pararenal area. It suggested malignant mediastinal tumor with multiple lung and bone metastases.

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  Figure 2 Chest computed tomography revealed a large irregular mass of 60 × 50 mm, in anterior mediastinum with the involvement of pericardiac recess, prericardium and subcarina. It also revealed the hematogenous lung metastases with hilar lymphadenopathy.

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  Figure 3 Photomicograph of the specimen. Sheets of highly atypical cells with pleomorphic nuclei and a high mitotic rate are seen. This finding is compatible with thymic carcinoma, undifferentiated type. (H&E stain, original magnification A: × 12, B: × 200)

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