伪装成定位性胸腔积液的幼儿大面积胸腺增生:病例报告

Emily J. Zolfaghari , Matthew Shaughnessy , Hao Wu , Michael Caty , Emily Christison-Lagay , Matthew A. Hornick
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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。
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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.

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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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