Thrombocytopaenia successfully treated by a multilocular thymic cyst resection

The multilocular thymic cyst (MTC) is a rare, acquired disease caused by inflammatory changes in the thymus, and is associated with autoimmune diseases. We report a case of MTC with thrombocytopaenia, which improved following surgical resection. A 45-year-old man developed thrombocytopaenia with an anterior mediastinal tumour. Thrombocytopaenia due to an autoimmune mechanism, associated with thymoma or thymus-related disease, was suspected. Pathologic analysis following thoracoscopic thymectomy confirmed MTC. The platelet level recovered postoperatively. Our findings suggested a relationship between the acquired formation of MTC and the development of autoimmune antibodies. However, further investigation is needed to obtain more information.

MEDIASTINAL THYMIC CYST IN A 50-YEAR-OLD MALE

Thymic CYSTs of the mediastinum are rare. It has been reported that their incidence is between 1 to 4.8%. They usually present as an asymptomatic mediastinal mass and are mostly found incidentally. This study reports a rare presentation of a mediastinal thymic CYST in a 50-year-old male, whose chronic right sided chest pain prompted him to visit a local hospital where his chest x-ray revealed a large mediastinal mass at the right cardiophrenic angle. His chest CT revealed a large multilocular hypodense cystic lesion that was resected completely by median sternotomy. On Histopathological examination, Hassals corpuscles confirmed the diagnosis of thymic CYST.

Multilocular Thymic Cyst in a Patient with Diffuse Infiltrative Lymphocytosis Syndrome

Diffuse Infiltrative Lymphocytosis Syndrome (DILS) is a multisystem disorder characterised by bilateral salivary gland enlargement and/or xerostomia in patients with Human Immunodeficiency Virus (HIV) infection. A 16 year old young male patient, presented with bilateral painless parotid swelling for five years. On evaluation, he was found to have oral thrush and bilateral cervical lymphadenopathy. He turned out to be positive for HIV with a cluster of differentiation 4 (CD4) count of 237/mcl. On Positron Emission Tomography- Contrast Tomography (PET-CT), a multiloculated thymic cyst (13×9×6 cm) was noted. He was diagnosed to have DILS with a large multiloculated thymic cyst. The patient was managed with tenofovir, lamivudine and efavirenz along with cotrimoxazole prophylaxis and fluconazole and was followed uptil nine months for the regress of the conditions. The case highlights the rare association between DILS and thymic cyst.