title: "Cryptic" mediastinal tuberculosis with myasthenia-thymoma complex.
abstract: Mediastinal tuberculosis, although common in endemic areas, is rare in association with myasthenia-thymoma complex. Immunosuppressive therapy for myasthenia with thymoma might increase the susceptibility for mediastinal tuberculosis. Previous reports suggest aggravation of myasthenic symptoms with this association. This rare combination of pathologies adds to the diagnostic dilemma of the surgeon. Further research is warranted in the management aspects of this combination as regards to the timing of radiotherapy, weaning of immunosuppression and anti-tubercular therapy after maximal thymectomy. This case report emphasises the possibility of mediastinal tuberculosis as a differential diagnosis for mediastinal lymphadenopathy in the setting of a preoperative diagnosis of invasive thymoma.
authors.affiliation: Consultant, Department of Cardiovascular and Thoracic Surgery, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, India.
authors.forename: George Jose
authors.initials: GJ
authors.lastname: Valooran
authors.affiliation: Senior Consultant and HOD, Department of Cardiovascular and Thoracic Surgery, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, India. Electronic address: shivnairmd@gmail.com.
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Nair
authors.affiliation: Consultant, Department of Cardiovascular and Thoracic Surgery, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, India.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Chandrasekharan
authors.affiliation: Consultant, Department of Pathology, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, India.
authors.forename: Sunitha
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Consultant, Department of Pathology, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, India.
authors.forename: Joejo
authors.initials: J
authors.lastname: John
mesh_terms: D005260:Female; D006801:Humans; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000382:microbiology; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis*; D013945:Thymoma / Q000175:diagnosis*; D013953:Thymus Neoplasms / Q000175:diagnosis*; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*
keywords: Anti-tubercular therapy; Invasive thymoma; Maximal thymectomy; Myasthenia gravis; Tuberculosis