Emily J. Zolfaghari , Matthew Shaughnessy , Hao Wu , Michael Caty , Emily Christison-Lagay , Matthew A. Hornick
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Consensus was to proceed with upfront surgical resection of the mass, which was performed via right thoracotomy. Pathology was consistent with true thymic hyperplasia. The post-operative course was uncomplicated, and no issues were identified at 3-month follow-up. We plan to follow the patient at 6 months, 1 year, and then annually with surveillance chest x-rays to monitor for recurrence case-report.</p></div><div><h3>Conclusion</h3><p>Thymic hyperplasia should be included in the differential diagnosis of pediatric patients with persistent respiratory symptoms and abnormal findings on chest x-ray.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001131/pdfft?md5=45ed11365993c746183d75987cd2ea86&pid=1-s2.0-S2213576624001131-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Massive thymic hyperplasia in a toddler masquerading as a loculated pleural effusion: A case report\",\"authors\":\"Emily J. 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We plan to follow the patient at 6 months, 1 year, and then annually with surveillance chest x-rays to monitor for recurrence case-report.</p></div><div><h3>Conclusion</h3><p>Thymic hyperplasia should be included in the differential diagnosis of pediatric patients with persistent respiratory symptoms and abnormal findings on chest x-ray.</p></div>\",\"PeriodicalId\":45641,\"journal\":{\"name\":\"Journal of Pediatric Surgery Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2213576624001131/pdfft?md5=45ed11365993c746183d75987cd2ea86&pid=1-s2.0-S2213576624001131-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Surgery Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213576624001131\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Surgery Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213576624001131","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
导言小儿胸腺大量增生是一种罕见疾病,可伪装成呼吸道疾病,因此诊断具有挑战性。病例介绍一名 18 个月大的女性患者,曾因疑似肺炎多次入院治疗,并使用抗生素,病史长达 3 个月,反复出现呼吸困难、发热和乏力。检查结果显示可能存在肺旁积液,包括六次胸部 X 光检查和一次超声波检查,最终进行了胸部计算机断层扫描(CT),发现一个巨大的均匀肿块占据了右侧胸腔的大部分。经皮核心活检显示,胸腺细胞提示大块胸腺增生或胸腺瘤。大家一致同意对肿块进行前期手术切除,手术是通过右胸廓切开术进行的。病理结果与真正的胸腺增生一致。术后过程并不复杂,3 个月随访时未发现任何问题。我们计划对患者进行 6 个月、1 年的随访,然后每年进行一次胸部 X 光检查,以监测复发情况。
Massive thymic hyperplasia in a toddler masquerading as a loculated pleural effusion: A case report
Introduction
Pediatric massive thymic hyperplasia is a rare condition that can masquerade as a respiratory illness, making diagnosis challenging.
Case presentation
An 18-month-old female with a 3-month history of multiple admissions for suspected pneumonia warranting antibiotics presented with recurrent respiratory distress, fevers, and fatigue. Work-up for possible parapneumonic effusion, including six chest x-rays and an ultrasound, eventually led to a computed tomography (CT) of the chest, which revealed a large homogeneous mass occupying much of the right-hemithorax. Percutaneous core biopsy showed thymocytes suggestive of either a massive thymic hyperplasia or a thymoma. Consensus was to proceed with upfront surgical resection of the mass, which was performed via right thoracotomy. Pathology was consistent with true thymic hyperplasia. The post-operative course was uncomplicated, and no issues were identified at 3-month follow-up. We plan to follow the patient at 6 months, 1 year, and then annually with surveillance chest x-rays to monitor for recurrence case-report.
Conclusion
Thymic hyperplasia should be included in the differential diagnosis of pediatric patients with persistent respiratory symptoms and abnormal findings on chest x-ray.