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Lee, Choi, Kim, Jung, Yoon, Jeung, Yi, and Kim: A Case of Concurrent Thymic Carcinoma with Systemic Lupus Erythematosus
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(1): 67-70.

Published online: 31 January 2007

DOI: https://doi.org/10.4046/trd.2007.62.1.67

A Case of Concurrent Thymic Carcinoma with Systemic Lupus Erythematosus

Young Joo Lee, M.D., Sang Tae Choi, M.D., Se Hyun Kim, M.D., Kyung Soo Jung, M.D., Sul Hee Yoon, M.D., Soo Jin Jeung, M.D., Seung Woo Yi, M.D., Joo Hang Kim, M.D.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Address for Correspondence: Joo Hang Kim, M.D. Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752 Korea. Phone: 02-2228-8131, FAX: 02-392-1508, kjhang@yumc.yonsei.ac.kr

Received 29 November 2006       Accepted 28 December 2006

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

A thymic carcinoma is a rare malignant neoplasm of the thymus epithelium, which can be distinguished from a benign or invasive thymoma. Contrary to a thymoma, the association of a thymic carcinoma and autoimmune disease is rare, with only a few cases having been reported.
Herein, a case of thymic carcinoma diagnosed concurrently with systemic lupus erythematosus (SLE) is reported. A 49 year-old man presented at our clinic with myalgia. He was diagnosed with SLE, based on an oral ulcer, lymphopenia, and positive ANA and anti-Sm antibodies. Incidentally, a routine chest X-ray showed a large mediastinal mass. Pathological examination of the mediastinal mass revealed an undifferentiated thymic carcinoma, of WHO classification type C. Further work-up for staging showed multiple bone and lung metastases. With a palliative aim, he received systemic chemotherapy, but refused further chemotherapy after the 2nd course. Currently, the patient has not been followed up since the chemotherapy.

Keywords: Thymic carcinoma, Systemic lupus erythematosus, Autoimmune disease

Figures and Tables

Figure 1
Positron emission tomography revealed the strong FDG uptake on a large irregular mass in anterior mediastinum, multiple lung nodules with bilateral lymphadenopathy, the 8th T-spine, right iliac crest, and the posterior pararenal area. It suggested malignant mediastinal tumor with multiple lung and bone metastases.
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Figure 2
Chest computed tomography revealed a large irregular mass of 60 × 50 mm, in anterior mediastinum with the involvement of pericardiac recess, prericardium and subcarina. It also revealed the hematogenous lung metastases with hilar lymphadenopathy.
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Figure 3
Photomicograph of the specimen. Sheets of highly atypical cells with pleomorphic nuclei and a high mitotic rate are seen. This finding is compatible with thymic carcinoma, undifferentiated type. (H&E stain, original magnification A: × 12, B: × 200)
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