Invasive thymoma with pure red cell aplasia and amegakaryocytic thrombocytopenia

  • Takuya Onuki | onukitakuya@hotmail.com Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Yusuke Kiyoki Department of Hematology, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Sho Ueda Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Masatoshi Yamaoka Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Seiich Shimizu Department of Hematology, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
  • Masaharu Inagaki Department of General Thoracic Surgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.

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, Masaoka- Koga 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.

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Published
2016-12-09
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Section
Case Reports
Keywords:
amegakaryocytic thrombocytopenia, Cyclosporine, pure red cell aplasia, thymoma
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How to Cite
Onuki, T., Kiyoki, Y., Ueda, S., Yamaoka, M., Shimizu, S., & Inagaki, M. (2016). Invasive thymoma with pure red cell aplasia and amegakaryocytic thrombocytopenia. Hematology Reports, 8(4). https://doi.org/10.4081/hr.2016.6680