Abstract
BackgroundCervical thymoma is a rare thymic epithelial neoplasm. Evidence supports an increased risk of second primary malignancies in patients with thymoma. We report a rare case of a patient with synchronous cervical thymoma and diffuse large B-cell lymphoma.Case presentationAn 81-year-old Thai woman was referred for further treatment of diffuse large B-cell lymphoma at Siriraj Hospital, Bangkok, Thailand. While waiting for a review of the original pathological examination of a mass in the left neck and a mass in the left arm, the attending physician noticed ptosis of the upper eyelids, which was proven to be caused by myasthenia gravis. The final pathology review confirmed that the arm mass was diffuse large B-cell lymphoma, but the neck mass was cervical thymoma, type B1, not diffuse large B-cell lymphoma. Interestingly, the patient reported that the arm mass had been present for 2 years, while the neck mass had grown rapidly in the past month. A diagnostic challenge had arisen when the initial morphological evaluation was not performed with care, causing the first pathologist to misinterpret that the neoplastic cells in both masses were the same.ConclusionConcurrent cervical thymoma and diffuse large B-cell lymphoma were proven after a careful pathology review, leading to better clinical management.
Highlights
BackgroundCervical thymoma is a rare neoplasm of the thymic epithelium, which arises in an ectopic thymus that originated from an undescended thymus during embryonic development
Cervical thymoma is a rare thymic epithelial neoplasm
Concurrent cervical thymoma and diffuse large B-cell lymphoma were proven after a careful pathology review, leading to better clinical management
Summary
Cervical thymoma is a rare neoplasm of the thymic epithelium, which arises in an ectopic thymus that originated from an undescended thymus during embryonic development. We report a case of MG related to cervical thymoma and concurrent diffuse large B-cell lymphoma (DLBCL) in an 81-year-old woman. She was initially diagnosed with DLBCL involving two masses, one on Kunacheewa et al Journal of Medical Case Reports (2022) 16:10 the left side of the neck and the other on the left forearm. The patient was found to have MG-related cervical thymoma after pathologic review, while the forearm mass was confirmed to be DLBCL. Immunostaining for AE1/AE3 cytokeratins showed the typical reticular pattern of neoplastic thymic epithelium, confirming that the neck mass contained type B1 thymoma (Fig. 3).
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