Detection of thymoma in myasthenia gravis

Keesey, John M.D.
Bein, Marshall M.D.
Mink, Jerrold M.D.
Sample, Frederick M.D.
Sarti, Dennis M.D.
Mulder, Donald M.D.
Herrmann, Christian Jr. M.D.
Peter, James B. M. D., Ph.D.

Departments of Neurology (Drs. Keesey and Herrmann), Radiology (Drs. Rein, Mink. Sample, and Sarti) and Surgery (Dr. Mulder), UCLA School of Medicine, Los Angeles, and the Clinical Immunology Laboratories, Inc. (Dr. Peter). Santa Monica, CA.

Address correspondence and reprint requests to Dr. Keesey, Reed Neurological Research Center, 710 Westwood Plaza, Los Angeles, CA 90024.

Accepted for publication August 10, 1979.

Portions of this paper were presented at the annual meeting of the American Academy of Neurology, Los Angeles, April 1978

Neurology 30(3):p 233-239, March 1980.

Article abstract

Twenty patients with myasthenia gravis had chest radiography, conventional tomography, and computed tomography (CT) of the thorax within 1 month of thymectomy. Four of the six macroscopic tumors were detected on routine chest radiography; conventional tomography provided no additional information. CT detected all six macroscopic tumors and provided additional information that was not available by other procedures. However, 18 patients (90%) had anterior mediastinum densities on CT, which could not be distinguished preoperatively from thymic tumors. All six patients with macroscopic tumors had serum antistriational muscle antibody titers; this test was negative in 10 of 11 patients (91%) without thymoma. Chest radiography, CT of the thorax, and antistriational antibodies are the tests recommended for detection of a thymoma in patients with myasthenia gravis.