Type AB thymoma accompanied by pure red cell aplasia and Good syndrome with CMV infection of tumor cells

Abstract

Reported herein is a case of type AB thymoma accompanied by pure red cell aplasia (PRCA) and Good syndrome. The patient was a 55-year-old woman who was found to be anemic and to have an abnormal shadow at the left pulmonary hilus on routine medical examination. Bone marrow aspiration was performed and she was diagnosed as having PRCA. She also had hypogammaglobulinemia. The anemia was temporarily cured with oral prednisolone and cyclosporin A, and the patient underwent total thymectomy. The tumor was type AB thymoma, composed mainly of type A components; widespread spindle cell components showed slight to moderate infiltration of immature T-cells. In addition, CMV inclusion bodies were scattered throughout this tumor. The CMV-infected cells were tumor cells, because they were positive for pancytokeratin and negative for CD34. Several cases of Good syndrome with widespread CMV infection have been reported, but it is extremely rare for CMV-inclusion bodies to be found in tumor cells. No thymoma cases involving CMV infection of tumor cells have been reported.