Comparative Clinical Features and Immune Responses After Extended Thymectomy for Myasthenia Gravis in Patients With Atrophic Versus Hyperplastic Thymus

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Comparative Clinical Features and Immune Responses After Extended Thymectomy for Myasthenia Gravis in Patients With Atrophic Versus Hyperplastic Thymus Zhenguang Chen, MD, PhD, Honghe Luo, MD, Yanwen Peng, PhD, Lie Cai, RN, Jinli Zhang, MD, Chunhua Su, MD, PhD, Jianyong Zou, MD The Annals of Thoracic Surgery Volume 91, Issue 1, Pages 212-218 (January 2011) DOI: 10.1016/j.athoracsur.2010.08.041 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Microscopically, atrophic thymuses in MG patients showed decreasing cortex and medullary space, together with increases in adipose tissue (A). Atrophic thymuses were strongly immunostained with antibody to BAFF-R (B), CD19 (C), and CD21 (D). (Original magnification ×200. Bar, 100 μm.) There were significant differences in immunostaining for BAFF-R, CD19, and CD21 among atrophic, hyperplastic, and control thymuses (E). The Annals of Thoracic Surgery 2011 91, 212-218DOI: (10.1016/j.athoracsur.2010.08.041) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Increased serum concentrations of immunoglobulin G (IgG) 1 and 3 days after thymectomy of atrophic thymuses (A), with no changes in serum IgA (B) and IgM (C) concentrations after thymectomy of atrophic and hyperplastic thymuses. (Pre op = preoperation.) The Annals of Thoracic Surgery 2011 91, 212-218DOI: (10.1016/j.athoracsur.2010.08.041) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Kaplan-Meier plot of complete stable remission in patients dichotomized by thymic histologic assessment. Note that median complete stable remission was similar in patients with atrophic and hyperplastic thymuses (4.9 years versus 4.8 years; p = 0.513). (B) Kaplan-Meier plot of improvement in patients dichotomized by thymic histologic assessment. Note that median improvement was slower in patients with atrophic than with hyperplastic thymus (3.3 years versus 2.3 years; p = 0.005). The Annals of Thoracic Surgery 2011 91, 212-218DOI: (10.1016/j.athoracsur.2010.08.041) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions