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Clinical syndromes of thymus (thymus gland) damage
Last reviewed: 04.07.2025
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The clinical equivalent of wasting syndrome is the manifestation of congenital thymic aplasia. This is a rather rare disease characterized by lymphopenia and agammaglobulinemia. It usually manifests itself after three months of age with severe diarrhea that does not respond to treatment. Cachexia, persistent cough, stiff neck, and a measles-like rash develop. Specific antibodies and isoagglutinins are completely absent from the blood serum. The prognosis is extremely unfavorable, although there is evidence of a positive effect of thymus extracts. Autopsy reveals a poorly developed thymus, which does not contain Hassall's bodies, but is rich in mast cells. All lymphoid tissue is hypotrophic and is represented almost exclusively by reticular cells without lymphocytes and plasma cells.
An example of syndromes associated with hypertrophy of the thymus gland is hemolytic anemia of an autoimmune nature, as well as the already mentioned malignant myasthenia. True thymomas are found in 15% of patients with this disease, and another 60-70% have hypertrophy of the medulla of the thymus containing germinal centers. Plasma cells are present in the perivascular connective tissue of the thymus gland. The idea of an autoimmune nature is confirmed by the frequent combination of the disease with other autoimmune processes (disseminated lupus erythematosus), as well as the presence of antibodies to other tissues (thyroid gland), rheumatoid factor, etc. in the blood serum. The serum of patients contains specific antibodies not only to acetylcholine receptors of muscles, but also to intracellular muscle antigens. Removal of the thymus in the early stages after the onset of the disease often leads to a cure.
Morphological changes in the thymus (the appearance of germinal centers and plasma cells in it) are also observed in other autoimmune diseases.
Thymus tumors are quite rare (5-10% of all mediastinal tumors). Most of them are epithelial or lymphoepithelial thymomas containing characteristic clear cells. Sometimes these tumors are accompanied by a disorder of serum globulin synthesis (hypo- or hypergammaglobulinemia) and various anemias (pancytopenia, erythropenia, thrombopenia, etc.). A connection between small-cell epithelial thymomas and the development of Cushing's syndrome has been described. Removal of the thymus in such cases (especially in the presence of hematological changes) has a positive effect. Thymus tumors can be malignant, growing into surrounding tissues and metastasizing to the chest organs. Lymphoepithelial thymomas are detected in cases of granulomatous myocarditis and myositis. There is data (mainly experimental) on the role of thymus pathology in the genesis of lymphocytic leukemia.
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