Abstract
A well encapsulated thymoma, consisting of spindle-shaped epithelial cells and lymphoid cells, was surgically removed for a mediastinal mass. Then a 61-year-old man developed recurrent sore throats and persistent productive cough. He was diagnosed bronchiectasis by bronchogram and immunodeficiency by markedly reduced each class of Ig (120mg% IgG, 21mg% IgM, 11mg% IgA and less than 25IU/ml IgE). Numbers of peripheral blood lymph-cytes (PBL) were normal. E rosetting lymphocytes were 67% of PBL and surface Ig bearing lymphocytes were 3% of PBL. This result was suggested that Ig producing B lymphocytes decreased.
Lymphocyte stimulation with mitogens revealed a normal mitotic response to PHA and PWM, but a low response to Con A. Skin tests of PPD, Candida and DNCB were negative.
He developed recurrent Gram-positive coccal infection and candidiasis of respiratory tract at end stage. He died of cardiac failure.
The histopathologic findings: The germinal centers of spleen and any lymph nodes were not demonstrated and cell components of these paracortical areas were markedly reduced. The funfal vegetations with weak inflammatory reaction were demonstrated in cardiac muscle, lung and kidneys.
We think this syndrome is consisted of both humoral and cellular immunodeficiency.
