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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Allergy</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Allergy</journal-title><trans-title-group xml:lang="ru"><trans-title>Российский Аллергологический Журнал</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1810-8830</issn><issn publication-format="electronic">2686-682X</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">17122</article-id><article-id pub-id-type="doi">10.36691/RJA17122</article-id><article-id pub-id-type="edn">AUJWVJ</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Научные обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Thymomegaly in children and adults</article-title><trans-title-group xml:lang="ru"><trans-title>Тимомегалия у детей и взрослых</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0972-5238</contrib-id><contrib-id contrib-id-type="spin">3013-3522</contrib-id><name-alternatives><name xml:lang="en"><surname>Tibirkova</surname><given-names>Elena V.</given-names></name><name xml:lang="ru"><surname>Тибирькова</surname><given-names>Елена Викторовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>elena_tibirkova@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2674-4289</contrib-id><contrib-id contrib-id-type="spin">6037-1995</contrib-id><name-alternatives><name xml:lang="en"><surname>Belan</surname><given-names>Eleonora B.</given-names></name><name xml:lang="ru"><surname>Белан</surname><given-names>Элеонора Борисовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><email>belan.eleonora@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1475-9301</contrib-id><contrib-id contrib-id-type="spin">1815-9773</contrib-id><name-alternatives><name xml:lang="en"><surname>Nikiforova</surname><given-names>Elizaveta M.</given-names></name><name xml:lang="ru"><surname>Никифорова</surname><given-names>Елизавета Михайловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), Associate Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><email>maior10@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8078-6407</contrib-id><contrib-id contrib-id-type="spin">6997-9533</contrib-id><name-alternatives><name xml:lang="en"><surname>Zheltova</surname><given-names>Anastasia A.</given-names></name><name xml:lang="ru"><surname>Желтова</surname><given-names>Анастасия Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>zheltovaa@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Volgograd State Medical University</institution></aff><aff><institution xml:lang="ru">Волгоградский государственный медицинский университет</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2026-05-09" publication-format="electronic"><day>09</day><month>05</month><year>2026</year></pub-date><pub-date date-type="pub" iso-8601-date="2026-05-25" publication-format="electronic"><day>25</day><month>05</month><year>2026</year></pub-date><volume>23</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>214</fpage><lpage>220</lpage><history><date date-type="received" iso-8601-date="2026-03-24"><day>24</day><month>03</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-04-29"><day>29</day><month>04</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, ABV-press</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, АБВ-пресс</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">ABV-press</copyright-holder><copyright-holder xml:lang="ru">АБВ-пресс</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2028-05-25"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://rusalljournal.ru/raj/article/view/17122">https://rusalljournal.ru/raj/article/view/17122</self-uri><abstract xml:lang="en"><p>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.</p></abstract><trans-abstract xml:lang="ru"><p>Тимус представляет собой лимфоэпителиальный орган, располагающийся в верхнем отделе переднего средостения, и одновременно является центральным органом иммунной системы и железой внутренней секреции. Увеличение объема и массы тимуса выше предельных возрастных значений с сохранением нормальной гистоархитектоники называют тимомегалией. Тимомегалия встречается преимущественно у детей и может быть как идиопатической, так и вторичной, возникающей как феномен рикошета после воздействия различных стрессовых факторов или сопровождающей другие заболевания и состояния. Патогенетической основой считается дисфункция гипоталамо-гипофизарной системы. Тимомегалия, особенно выраженных степеней, часто сопровождается нарушением Т-клеточного иммунитета, а также уменьшением размеров надпочечников с угнетением их гормональной функции, в связи с чем лица с тимомегалией находятся в группе риска развития затяжных, осложненных и молниеносных форм инфекционных заболеваний. Инструментальными методами, позволяющими обнаружить тимомегалию, являются рентгенография органов грудной клетки и ультразвуковое исследование тимуса. Тимомегалия может быть выявлена и при компьютерной/магнитно-резонансной томографии органов грудной клетки. Тимическое развитие Т-лимфоцитов оценивают путем исследования Т-рецепторных эксцизионных колец в крови методом полимеразной цепной реакции. В комплекс терапевтических и профилактических мероприятий при тимомегалии входят коррекция нарушений Т-клеточного иммунитета (при их наличии), персонализированный подход к вакцинации, предоперационная подготовка и тщательное наблюдение в послеоперационном периоде. Вопрос о тимэктомии решается индивидуально. Прогноз у детей чаще благоприятный, у взрослых — зависит от причины.</p></trans-abstract><kwd-group xml:lang="en"><kwd>thymomegaly</kwd><kwd>T-cell dysfunction</kwd><kwd>adrenal insufficiency</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>тимомегалия</kwd><kwd>нарушение Т-клеточного иммунитета</kwd><kwd>надпочечниковая недостаточность</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Tolstova EM, Zaitseva OV. Thymus physiology and pathology in childhood. 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