A patient with a thymoma may develop hypoplasia in one or more marrow lineages.


Clinical features:

(1) presence of a thymoma

(2) presence of pancytopenia or anemia

(3) hypoplasia in one or more marrow lineages in the bone marrow biopsy

(4) absence of alternative explanation

(5) positive response to therapy targeting the thymoma and associated immunologic disorders


Theories for occurrence:

(1) antibody that interferes with precursor proliferation

(2) infiltration of the bone marrow with T-cells (CD4+, CD8+) or natural killer (NK)-cells

(3) soluble inhibitor in the serum


Therapy may include:

(1) complete resection of the thymoma

(2) steroids and cyclophosphamide

(3) cyclosporine A (if other regimens fail)


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