Imaging findings of spontaneous thymic hemorrhage in infancy: Case report and literature review
DOI:
https://doi.org/10.46475/aseanjr.v21i2.71Keywords:
Thymic hemorrhage, Spontaneous hemorrhage, Bleeding tendency, Factor 7 deficiency, Infancy, ThymusAbstract
The authors report imaging findings of spontaneous thymic hemorrhage, which is a rare entity in infancy, in a 4-month-old boy with congenital factor VII deficiency presented with acute respiratory distress and anemia. Widening of superior mediastinum and left
pleural effusion were detected on the chest radiograph. Ultrasound and computed tomography of the chest revealed diffusely enlarged thymus with heterogeneous parenchyma from poorly-defined areas of altered echogenicity or attenuation. Vascular flow was depicted within the abnormal thymus in color-mode sonography. The
spontaneous involution of thymic abnormality seen on serial ultrasonography confirmed the diagnosis of thymic hemorrhage, resulting in avoidance of further unnecessary imaging or invasive procedure.
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Han BK, Suh YL, Yoon HK. Thymic ultrasound. I. Intrathymic anatomy in infants.Pediatr Radiol 2001;31:474-9.
Webb WR. The mediastinum: mediastinal masses. In: Webb WR, Higgins CB. Thoracic imaging: pulmonary and cardiovascular radiology. 2 nd ed. Philadelphia PA: Lippincott Williams & Wilkins; 2011. p.219-85.
Woolley MM, Isaacs H Jr, Lindesmith G, Vollmer DM, Van Adelsberg S.Spontaneous thymic hemorrhage in the neonate: report of two cases. J Pediatr Surg 1974;9:231-3.
Lemaitre L, Leclerc F, Dubos JP, Marconi V, Lemaire D. Thymic hemorrhage: a cause of acute symptomatic mediastinal widening in an infant with late haemorrhagic disease. Sonographic findings. Pediatr Radiol 1989;19:128-9.
Urvoas E, Pariente D, Rousset A, De Victor D, Leblanc A. Ultrasound diagnosis of thymic hemorrhage in an infant with late-onset hemorrhagic disease. Pediatr Radiol 1994;24:96-7.
Walsh SV, Cooke R, Mortimer G, Loftus BG. Massive thymic hemorrhage in a neonate: an entity revisited. J Pediatr Surg 1996;31:1315-7.
Bees NR, Richards SW, Fearne C, Drake DP, Dicks-Mireaux C. Neonatal thymic haemorrhage. Br J Radiol 1997;70:210-2.
Gargano G, Paltrinieri AL, Gallo C, Di Pancrazio L, Roversi MF, Ferrari F. Massive thymic hemorrhage and hemothorax occurring in utero. Ital J Pediatr 2015 Nov14;41:88. https://doi.org/10.1186/s13052-015-0196-5.
Palau MA, Winters A, Liang X, Nuss R, Niermeyer S, Gossling M, et al. Vitamin K deficiency presenting in an Infant with an anterior mediastinal mass: A case report and review of the literature. Case Rep Pediatr 2017;2017:7628946. https://doi.org/10.1155/2017/7628946.
Ghoshhajra K. Spontaneous thymic hemorrhage in an adult. Chest 1977;72:666-8.
Sakuraba M, Tanaka A, Tsuji T, Mishina T. Spontaneous thymic hemorrhage in an adult. Ann Thorac Surg 2014 May;97(5):1800-2. https://doi.org/10.1016/j.athoracsur.2013.07.098.
de Perrot M, Bründler MA, Girardet C, Spiliopoulos A. Spontaneous hemorrhage of thymus and thymoma in adults. Eur J Cardiothorac Surg 1999;16:674-6.
Yekeler E, Tambag A, Tunaci A, Genchellac H, Dursun M, Gokcay G, et al. Analysis of the thymus in 151 healthy infants from 0 to 2 years of age. J Ultrasound Med 2004;23:1321-6.
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