Imaging findings of spontaneous thymic hemorrhage in infancy: Case report and literature review

Chanunporn Leekumnerdthai; Panruethai Trinavarat; Darintr Sosothikul; Nattinee Leelakanok

doi:10.46475/aseanjr.v21i2.71

Authors

Chanunporn Leekumnerdthai, M.D. Department of Radiology, Bhumibol Adulyadej Hospital, The Royal Thai Airforce, Bangkok, Thailand
Panruethai Trinavarat, M.D. Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Darintr Sosothikul, M.D. Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Nattinee Leelakanok, M.D. Department of Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

DOI:

https://doi.org/10.46475/aseanjr.v21i2.71

Keywords:

Thymic hemorrhage, Spontaneous hemorrhage, Bleeding tendency, Factor 7 deficiency, Infancy, Thymus

Abstract

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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