[Multilocular thymic cyst associated with rheumatoid arthritis].

A 66-year-old woman had been receiving treatment for rheumatoid arthritis( RA) since her 28 years of age. Chest computed tomography( CT) taken during follow-up showed an anterior mediastinal tumor of 35×20×65 mm in size as a region of heterogeneous internal density. Accumulation of 18F-fluorodeoxyglu cose was identified on positron emission tomography( PET)[ maximum standardized uptake value( SUV max) 8.7]. Thymic epithelial tumor( thymoma or thymic cancer) with cystic degeneration was initially suspected, so total thymectomy was performed. A multilocular, non-invasive tumor mass was completely resected. Pathological diagnosis was lymphoid follicular hyperplasia with concomitant multilocular thymic cyst( MTC). Surgery resulted in alleviation of RA symptoms and a decreased inflammatory response. Inflammation due to autoimmune disease is believed to play an important role in the formation of MTC. In the present case, surgery may have inhibited the progression of RA.

Preoperative granulocyte-colony stimulating factor (G-CSF) treatment improves congested liver regeneration.

BACKGROUND: Hepatic venous congestion after liver surgery can cause liver failure. We evaluated the effectiveness of granulocyte-colony stimulating factor (G-CSF) for regeneration of remnant liver with venous congestion. MATERIALS AND METHODS: Rats were divided into three groups. Group A underwent 60% hepatectomy. Group B underwent 60% hepatectomy with partial venous congestion in remnant liver. Group C underwent the same procedures as group B with G-CSF given preoperatively for 5 d. To evaluate liver regeneration in each group at 1, 2, 3, 5, and 7 d postoperatively, the proliferating cell nuclear antigen (PCNA) labeling index (LI), mitotic index (MI) in the congested area of remnant liver, and regeneration rate of remnant liver weight were measured. CD34 antibody-positive hematopoietic stem cell (HSC) colonies were identified using immunopathological staining. RESULTS: Compared with group B, in group C, LI, and MI in congested remnant liver increased earlier, peak LI value in the congested area appeared 24h earlier, and full recovery of remnant liver weight occurred 2 d earlier. On postoperative day 3, remnant liver weight was significantly greater in group C than group B. On microscopy, CD34-positive cells were seen in preoperative group C livers. CONCLUSION: Preoperative G-CSF improves regeneration of livers with venous congestion.