Age-related changes in the thymus gland: CT-pathologic correlation

Moore, Arl Van; Korobkin, Melvyn; Olanow, Warren; Heaston, D K; Ram, Panol C.; Dunnick, N. Reed; Silverman, Paul M.

doi:10.2214/ajr.141.2.241

Cited by 71 publications

(38 citation statements)

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“…Chest computerized tomograms (CT) have been used to identify thymus tissue in vivo in adults (18)(19)(20) and in the analysis of thymopoiesis in adults with HIV-1 infection (21). In patient no.…”

Section: Analysis Of Thymus Tissue In Patients Who Died With Complicamentioning

confidence: 99%

Analysis of the adult thymus in reconstitution of T lymphocytes in HIV-1 infection

Haynes¹,

Hale²,

Weinhold³

et al. 1999

J. Clin. Invest.

170

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Section: Analysis Of Thymus Tissue In Patients Who Died With Complicamentioning

confidence: 99%

Analysis of the adult thymus in reconstitution of T lymphocytes in HIV-1 infection

Haynes¹,

Hale²,

Weinhold³

et al. 1999

J. Clin. Invest.

170

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“…Although it is active in utero and in early life, intrathymic T cell production diminishes progressively with age. Numerous studies by autopsy (1)(2)(3)(4)(5)(6)(7)(8), biopsy (9), and computed tomography (CT) 1 (10)(11)(12) indicate that the volume of true thymic tissue (excluding perivascular space, adipose and fibrous tissue) diminishes progressively throughout life. These observations are consistent with clinical studies showing that, postmyeloablation, circulating naive CD4 ϩ and CD8 ϩ T cells are only found after relatively long periods of time (4-6 mo) and then usually in children and young adults (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

High prevalence of thymic tissue in adults with human immunodeficiency virus-1 infection.

McCune¹,

Loftus²,

Schmidt³

et al. 1998

J. Clin. Invest.

244

149

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The thymus in adults infected with the HIV-1 is generally thought to be inactive, both because of age-related involution and viral destruction. We have revisited the question of thymic function in adults, using chest-computed tomography (CT) to measure thymic tissue in HIV-1-seropositive ( n ϭ 99) or HIV-1-seronegative ( n ϭ 32) subjects, and correlating these results with the level of circulating CD4 ϩ and CD8 ϩ T cells that are phenotypically described as naive thymic emigrants. Abundant thymic tissue was detectable in many (47/99) HIV-1-seropositive adults, aged 20-59. Independent of age, radiographic demonstration of thymic tissue was significantly associated with both a higher CD4 ϩ T cell count ( P ϭ 0.02) and a higher percentage and absolute number of circulating naive (CD45RA ϩ CD62L ϩ ) CD4 ϩ T cells ( P Ͻ 0.04). The prevalence of an abundant thymus was especially high in younger HIV-1-seropositive adults ( Յ 39 yr) with CD4 counts in the range 300-500 cells/ l and in older subjects ( Ͼ 40 yr) regardless of CD4 count ( P ϭ 0.03). These studies suggest that the thymus is functional in some but not all adults with HIV-1 disease. ( J. Clin. Invest. 1998.

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“…Besides tumor size, the lesion shape provides additional information for this differential diagnosis. The maintenance of a triangular shape (transversal cut) is suggestive of thymus hyperplasia (5,13).…”

Section: Discussionmentioning

confidence: 99%

Thymus hyperplasia after resolution of hypercortisolism in ACTH-dependent Cushing’s syndrome: the importance of thymic vein catheterization

Neto

Machado²,

Mesquita³

et al. 2006

eur j endocrinol

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Thymic hyperplasia has been described after the resolution of hypercortisolism from several etiologies, causing great diagnostic dilemmas. We describe a case where the catheterization of the thymic vein was essential for the differential diagnosis of a thymic enlargement in an adrenalectomized patient with ACTH-dependent Cushing's syndrome. The patient was a 48-year-old female with clinical and laboratorial data suggesting Cushing's disease. She underwent a transsphenoidal surgery with no tumor visualization and no remission of the syndrome. Histopathological studies disclosed a normal pituitary. She underwent a bilateral adrenalectomy and 8 months later a chest CT showed an increase of left thymic lobe, which was previously non-existent. After a negative 111 In-pentetreotide scintigraphy, the patient underwent simultaneous and bilateral catheterism of the petrosus sinuses and catheterization of the thymic and inominate veins and no ACTH gradient was shown among the sites of collection. She did not undergo thoracotomy and a follow-up was established. During the evolution, there was a spontaneous regression of the thymic lesion 38 months after the diagnosis. The ACTH gradient during the catheterization of thymic vein was essential for the differential diagnosis of the thymic enlargement tumor after hypercortisolism resolution in ACTH-dependent Cushing's syndrome, especially in this case, where the ACTH source was occult, thus avoiding an invasive surgical procedure for a benign entity with spontaneous resolution.European Journal of Endocrinology 154 807-811

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Age-related changes in the thymus gland: CT-pathologic correlation

Cited by 71 publications

References 0 publications

Analysis of the adult thymus in reconstitution of T lymphocytes in HIV-1 infection

Analysis of the adult thymus in reconstitution of T lymphocytes in HIV-1 infection

High prevalence of thymic tissue in adults with human immunodeficiency virus-1 infection.

Thymus hyperplasia after resolution of hypercortisolism in ACTH-dependent Cushing’s syndrome: the importance of thymic vein catheterization

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