Abstract
Of the 26 patients with myasthenia gravis undergone thymectomy, 11 cases had either benign or malignant thymoma as judged not only by hitological examination but also by their clinical and operative findings. Age of initial onset ranged from 13 to 64 years old. Fifteen out of 26 (58 per cent) benefited from thymectomy. Duration of the symptom from the onset to the operation and the presence or absence of the thymoma are not related to their outcome. Benign or malignant nature of thymoma should not be determined by histological examination alone but by combined evaluation of clinical and operative findings. Serial studies of serum immunoglobulin levels before and after thymectomy suggested that this disorder could be associated with humoral antibody (IgG). HLA typing of the patients with myasthenia gravis did not indicate the presence of any specific antigens.
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Alpert, L.I., Papatestas, A., Kark, A., Osserman R.S. and Osserman, K.: A histologic reappraisal of the thymus in myasthenia gravis. A correlative study of thymic pathology and response to thymectomy.Arch. Path. 91: 55–61, 1971.
Armstrong, R.M., Nowak, R.M. and Falk, R.E.: Thymic lymphocyte function in myasthenia gravis,Neurology 23: 1078–1083, 1973.
Bernatz, P.E., Harrison, E.G. and Clagett, O. T.: Thymoma: A clinicopathologic study,J. Thorac. & Cardiovas. Surg. 42: 424–444, 1961.
Blalock, A., Mason, M. F., Morgan, H.J. and Riven, S.S.: Myasthenia gravis and tumors of the thymic region,Ann. Surg. 110: 544–561, 1939.
Castleman, B.: Tumor of the thymus gland, in Armed Forces Institute of Pathology, Atlas of tumor pathology, Sect. 5, Fasc. 19, Washington, D.C.: National Research Council, 1955.
Feltkamp, T.E.W., Van den Berg-Loonen, P.M., Nijenhuis, L.E., Engelfriet, C.P., Van Rossum, A.L., Van Loghem, J.J. and Oosterhuis, H.J.G.H.: Myasthenia gravis, Autoantibodies, and HLA antigens,Bri. Med. J. 1: 131–133, 1974.
Fritze, D., Herrmann, C., Smith, G.S. and Walford, R.L.: HLA types in myasthenia gravis,Lancet 2: 211, 1973.
Fritze, D., Herrmann, C., Naeim, F., Smith, G.S. and Walford, R.L.: HLA antigens in myasthenia gravis,Lancet 1: 240–242, 1974.
Fudenberg, H.H., Good, R.A., Goodman, H.C., Hitzig, W., Kunkel, H.G., Roitt, I.M., Rosen, F.S., Rowe, D.S., Seligmann M. and Soothill, J.R.: Primary immunodeficiencies. Reports of World Health Organization Committee,Pediatrics 47: 927–946, 1971.
Iverson, L.: Thymoma. A review and reclassification,Amer. J. Pathol. 32: 685–719, 1956.
Keynes, G.: Investigation into thymic disease and tumor formation,Bri. J. Surg. 42: 449–462, 1955.
Kott, E. and Rule, A.H.: Myasthenia gravis: Cellular response to basic myelin protein compared with cellular and humoral immunity to muscle antigens,Neurology 23: 745–748, 1973.
Mancini, J., Carbonara, A.O. and Heremans, J.D.: Immunochemical quantitation of antigens by single radical immunodiffusion,Immunochemistry 2: 235–254, 1965.
Minkowitz, S., Solomon, L. and Nigastri, A.D.: Cytologically malignant thymoma with distant metastasis,Cancer 21: 426–433, 1968.
Miyyal, K.K., Mickey, M.R., Singal, D.P. and Terasaki, P.I.: Serotyping for homotransplantation. XV111. Refinement of microdroplet lymphocyte cytotoxicity test,Transplantation 6: 913–927, 1968.
Mulder, D.G., Herrmann, C. and Buckberg, G.D.: Effect of thymectomy in patients with myasthenia gravis. A sixteen year experience,Amer. J. Surg. 128: 202–206, 1974.
Osserman, K.E.: Myasthenia gravis, Grune and Strutton, New York, 1958.
Papatestas, A.E., Alpert, L.I., Osserman, K.E., Osserman, R.S. and Kark, A.E.: Studies in myasthenia gravis: Effect of thymectomy, Results on 185 patients with nonthymomatous and thymomatous myasthenia gravis, 1941–1969,Amer. J. Med. 50: 465–474, 1971.
Ryder, L.P., Nielsen, L.S. and Svejgaard, A.: Associations between HLA histocompatibility antigens and non-malignant disease,Humangenetik 25: 251–264, 1974.
Sabiston, D.C. and Oldham, H.N.: The mediastinum, in Gibbon's surgery of the chest, W.B. Saunders, Philadelphia, 1976.
Seybold, W.D., McDonald, J.R., Clagett, O.T. and Good, C.A.: Tumor of thymus,J. Thorac. Surg. 20: 195–215, 1950.
Shield, T.W., Fox, R.T. and Lees, W.M.: Thymic tumors: Classification and treatment,Arch. Surg. 92: 617–622, 1966.
Terasaki, P.I. and McClleland, J.D.: Microdroplet assay for human serum cytotoxins,Nature 204: 998–1000, 1964.
White, R.G. and Marshall, A.H.E.: The autoimmune response in myasthenia gravis,Lancet 2: 120–123, 1962.
Wilkins, E.W., Edmunds, L.H. and Castleman, B.: Case of thymoma at the Massachusetts General Hospital,J. Thorac. & Cardiovas. Surg. 52: 322–330, 1966.
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Konomi, K., Toyoda, S., Nishikata, F. et al. Role of thymectomy in the surgical treatment of myasthenia gravis. The Japanese Journal of Surgery 9, 24–31 (1979). https://doi.org/10.1007/BF02468712
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DOI: https://doi.org/10.1007/BF02468712