title: Invasive Thymoma with Pure Red Cell Aplasia and Amegakaryocytic Thrombocytopenia.
abstract: We here describe a case involving a 67-yearold female patient who was referred to our hospital due to severe anemia (hemoglobin, 5.0 g/dL), thrombocytopenia (platelet count, 0.6 × 104/μL), and a mediastinal shadow with calcification noted on X-ray. On admission, an anterior mediastinal tumor was detected, and bone marrow biopsy revealed few megakaryocytes and severely reduced numbers of erythroid cells. The diagnosis was thymoma with pure red cell aplasia (PRCA) and acquired amegakaryocytic thrombocytopenia (AAMT). On Day 8 of admission, the patient received immunosuppressive therapy together with cyclosporine for the 2 severe hematologic diseases, which were stabilized within 2 months. Subsequently, total thymectomy was performed. The diagnosis of the tumor invading the left lung was invasive thymoma, Masaokakoga stage III. The histological diagnosis was World Health Organization type AB. Thymoma accompanied with PRCA and AAMT is very rare, and, based on our case, immunotherapeutic therapy for the hematologic disorders should precede surgical intervention.
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital , Ibaraki, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Onuki
authors.affiliation: Department of Hematology, Tsuchiura Kyodo General Hospital , Ibaraki, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kiyoki
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital , Ibaraki, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital , Ibaraki, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yamaoka
authors.affiliation: Department of Hematology, Tsuchiura Kyodo General Hospital , Ibaraki, Japan.
authors.forename: Seiich
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital , Ibaraki, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Inagaki
keywords: Amegakaryocytic thrombocytopenia; Cyclosporine; Pure red cell aplasia; Thymoma