Thymoma-associated multiorgan autoimmunity: A graft-versus-host–like disease - 19/08/11

Doi : 10.1016/j.jaad.2007.02.027

Akhil Wadhera, MD ^a,^b, Emanual Maverakis, MD ^b, Nicholas Mitsiades, MD ^c, Primo N. Lara, MD ^d, Maxwell A. Fung, MD ^a,^e, Peter J. Lynch, MD ^b,^⁎
^a Permanente Medical Group, Fremont, California
^b Department of Dermatology, University of California Davis, Sacramento, California
^d Department of Internal Medicine, University of California Davis, Sacramento, California
^e Department of Pathology, University of California Davis, Sacramento, California
^c Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts

Reprint requests: Peter J. Lynch, MD, Department of Dermatology, University of California Davis, 3301 C St, Suite 1412, Sacramento, CA 95816.

Abstract

Graft-versus-host disease (GVHD) is a T cell–mediated disease seen most commonly after hematopoietic stem cell transplantation. Rarely, a GVHD-like disease can be seen in patients with malignant thymoma. We describe a 50-year-old man with malignant thymoma who developed skin, liver, and intestinal manifestations similar to that seen in GVHD. We also review other reported cases of GVHD-like manifestations in the setting of thymoma and propose “thymoma-associated multiorgan autoimmunity” as a name for this novel disease. Specifically, thymoma-associated multiorgan autoimmunity is defined as a disease of the liver, intestine, or skin, which on histopathology resembles GVHD but is seen in the setting of malignant thymoma and not after hematopoietic stem cell transplantation.

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Abbreviations used : GVHD, HSCT, MHC, Ta, TAMA

Plan

Case report

Discussion

	A. Wadhera coordinated the dermatologic treatment of the patient and prepared Table I. E. Maverakis wrote the manuscript, collected data for the publication, and coined the new disease name TAMA. P. Lynch proposed GVHD as the patient’s diagnosis and collected data for the publication. M. Fung interpreted the dermatopathology. N. Mitsiades served as a source of technical expertise and helped in revising the manuscript. P. Lara was the oncologist. He served as a source of technical expertise. All authors proofed the manuscript and made suggestions during its preparation.
	Funding sources: None.
	Conflicts of interest: None declared.