Thymomegaly in children and adults

The thymus is a lymphoepithelial organ located in the upper part of the anterior mediastinum and is both the central organ of the immune system and the endocrine gland. An increase in the volume and mass of the thymus above the age limits while maintaining normal histoarchitectonics is called thymomegaly. Thymomegaly occurs mainly in children and can be both idiopathic and secondary, occurring as a rebound phenomenon after exposure to various stress factors or accompanying other diseases and conditions. The pathogenetic basis for this is considered to be the dysfunction of the hypothalamic-pituitary system. Thymomegaly, especially severe degrees, is often accompanied by a violation of T-cell immunity, as well as a decrease in the size of the adrenal glands with suppression of their hormonal function, and therefore individuals with thymomegaly are at risk of developing prolonged, complicated, and fulminant forms of infectious diseases. Instrumental methods for thymomegaly detecting are chest X-ray and thymic ultrasound. Thymomegaly can also be detected by computed tomography/magnetic resonance imaging of the chest. Thymic T-lymphocyte development is assessed by detection of T-receptor excision circles in the blood using polymerase chain reaction. The complex of therapeutic and preventive measures for thymomegaly includes T-cell immunity disorder correction (if present), a personalized vaccination approach, preoperative preparation, and careful monitoring in the postoperative period. The need for thymectomy is determined individually. The prognosis in children is more often favorable, in adults it depends on the cause.