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Vol.41 No.4 contents | Japanese/English |
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- Case Report -
Three Cases of Pure Red Cell Aplasia Related to Thymoma
Hidehito Matsuoka, Noriaki Tsubota, Wataru Nishio, Toshihiko Sakamoto, Hiroaki Harada and Terumasa Sashikata*The Department of Thoracic Surgery and *Pathology, Hyogo Medical Center for Adults, Akashi, Hyogo, Japan
Background: Various kinds of treatment including thymo-thymectomy have been tried for pure red cell aplasia (PRCA) with thymoma. Case: Case 1 was a 57-year-old woman with severe anemia. Peripheral blood examination revealed few reticulocytes. Cytologic examination of bone marrow aspiration showed that there were few erythloblasts. A computed tomography of the chest showed an anterior mediastinal tumor. Under a diagnosis of thymoma with PRCA, thymo-thymectomy was performed. The tumor was histologically diagnosed as a stage II mixed type thymoma. The anemia improved immediately after operation. Case 2 was a 58-year-old man with severe anemia. He had the same clinical characteristics as Case 1 and thymo-thymectomy was indicated. Anemia did not improve although prednisolone was given after the operation. The administration of cyclosporin (6 mg/kg/day) markedly improved the anemia. Case 3 was 75-year-old man with no anemia. A computed tomography of the chest showed an anterior mediastinal tumor. Under a diagnosis of localized thymoma, thymo-thymectomy was performed. The tumor was histologically diagnosed as a stage III lymphocyte-dominant thymoma. Two years later he was found to have B-cell non-Hodgkin's lymphoma and received radiotherapy. Four years after radiotherapy peripheral blood examination revealed marked anemia and few reticulocytes. Cytologic examination of bone marrow aspiration showed that there were few erythloblasts. Under a diagnosis of PRCA, cyclosporin (3 mg/kg/day) was administered. The anemia markedly improved following the administration. Conclusion: The administration of cyclosporin is recommended as the first-line therapy for synchronous or metachronous PRCA with thymoma.
key words: Pure red cell aplasia, Thymoma, Cyclosporin
Received: April 25, 2001
Accepted: May 31, 2001
JJLC 41 (4): 329-332, 2001
