title: Massive thymic hemorrhage and hemothorax occurring in utero.
abstract: BACKGROUND
  Thymic enlargement is a common and physiological finding in children and neonates' X-rays, but it is usually asymptomatic. Occasionally it can cause respiratory distress. In most cases the aetiology of this expansion remains unclear and it is diagnosed as a thymic hyperplasia. True thymic hyperplasia is defined as a gland expansion, both in size and weight, while maintaining normal microscopic architecture. Often it is a diagnosis of exclusion and prognosis is good. Thymic haemorrhage is an unusual condition related to high foetal and neonatal mortality.
  
  
  METHODS
  We report a case of spontaneous massive thymic haemorrhage in a newborn developing at birth acute respiratory distress associated with severe bilateral haemothorax. Thymic enlargement was evident after pleural evacuation and confirmed by radiographic, Computed Tomography (CT) images and Magnetic Resonance Imaging (MRI) sequences. The spontaneous resolution of this enlargement seen with CT scan and MRI sequences suggested a thymic haemorrhage; surgery was not necessary.
  
  
  CONCLUSIONS
  Thymic haemorrhage should be considered in newborn infants with pleural effusion, mediastinal space enlargement and Respiratory Distress.
authors.affiliation: Department of Obstetric and Pediatric, Neonatal Intensive Care Unit (NICU), Arcispedale S. Maria Nuova, Istituto Tecnologie Avanzate e Modelli Assistenziali in Oncologia-IRCCS, Viale Risorgimento n. 70, 42100, Reggio Emilia, Italy. giancarlo.gargano@asmn.re.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Gargano
authors.affiliation: Department of Obstetric and Pediatric, Neonatal Intensive Care Unit (NICU), Arcispedale S. Maria Nuova, Istituto Tecnologie Avanzate e Modelli Assistenziali in Oncologia-IRCCS, Viale Risorgimento n. 70, 42100, Reggio Emilia, Italy. alpaltrinieri@gmail.com.
authors.forename: Anna Lucia
authors.initials: AL
authors.lastname: Paltrinieri
authors.affiliation: Department of Obstetric and Pediatric, Neonatal Intensive Care Unit (NICU), Arcispedale S. Maria Nuova, Istituto Tecnologie Avanzate e Modelli Assistenziali in Oncologia-IRCCS, Viale Risorgimento n. 70, 42100, Reggio Emilia, Italy. gallo.claudio@asmn.re.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gallo
authors.affiliation: Department of Radiology, University Hospital, Modena, Italy. dipancrazio.luciana@policlinico.mo.it.
authors.forename: Luciana
authors.initials: L
authors.lastname: Di Pancrazio
authors.affiliation: Department of Obstetric and Pediatric, Neonatal Intensive Care Unit (NICU), University Hospital, Modena, Italy. roversi.federica@policlinico.mo.it.
authors.forename: Maria Federica
authors.initials: MF
authors.lastname: Roversi
authors.affiliation: Department of Obstetric and Pediatric, Neonatal Intensive Care Unit (NICU), University Hospital, Modena, Italy. ferrari.fabrizio@unimore.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ferrari
mesh_terms: D005315:Fetal Diseases / Q000175:diagnosis*; D006470:Hemorrhage / Q000175:diagnosis* / Q000196:embryology; D006491:Hemothorax / Q000175:diagnosis* / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011296:Prenatal Diagnosis / Q000379:methods*; D013950:Thymus Gland / Q000098:blood supply* / Q000196:embryology