A Case of a Thymoma Accompanied by Pure Red Cell Aplasia Presented with Anemia

Abstract

A 63-year-old man who had been aware of having exertional malaise for 6 months presented to a neighboring hospital because of dizziness occurred one month earlier. Anemia was identified and he was referred to our hospital for close exploration. As a result, pure red cell aplasia was diagnosed and blood transfusion was performed. A chest CT scan during the close exploration showed an anterior mediastinal tumor which was suspected to be a thymoma. Therapeutic guidelines for the patient were discussed in our hospital, and we decided to precede with surgery before initiating the medical treatment with immunosuppressors. At surgery, extended thymectomy through the median sternotomy was performed. The patient's postoperative course was uneventful. The histopathological diagnosis was type AB thymoma according to the WHO classification. Although he needed several times of blood transfusions due to anemia before the surgery, postoperative progression of anemia became gradual. Blood transfusion was conducted on the postoperative day 30 for progressing anemia and oral administration of cyclosporin was started. Thereafter, anemia improved, and he did not require additional blood transfusion. We present a case of a thymoma associated with pure red cell aplasia, together with a review of the relevant Japanese literature.