Abstract
Two cases of red cell aplasia with multiple immunological abnormalities that developed after resection of thymoma are reported.
A 71 year-old woman was admitted because of anemia and neutropenia in August, 1985. In April, 1985, thymectomy was performed for the major tumor of a lymphocytic type thymoma, remaining pleural metastais unresected. On admission, RBC was 316×104/mm3, reticulocytes 0% and WBC 700/mm3. Bone marrow aspiration revealed complete loss of erythroid components and myeloid hypoplasia. Hypogammaglobulinemia was present and anti-nuclear factors, anti-microsome and antithyroglobulin antibodies were positive. 70% of lymphocytes were Leu 2a positive. After short term of spontaneous remission, anemia and neutropenia developed again. The patients died of pneumonia without knowing the effects of anti-lymphocyte serum.
The other case was a 46 year-old man, who developed pure red cell aplasia 6 years after resection of a lymphoepithelial type thymoma. Thymoma relapsed 3 years after the diagnosis of PRCA, and it was surgically treated again. Anti-nuclear factors, anti-erythroblast antibodies and a false positive test for syphilis were detected. Anemia did not respond to medical treatment and the patient died of acute myocardial infarction.
In both cases, autopsy failed to show any remained thymoma.
Anemia developing after thymectomy is discussed with a review of literaure.
