True thymic hyperplasia associated with thymic hemorrhage in an adult patient
Department of Experimental Medicine and Pathology, II Faculty of Medicine, Sant'Andrea Hospital, University La Sapienza, Rome, Italy.Pathology - Research and Practice (Impact Factor: 1.4). 08/2009; 206(5):331-3. DOI: 10.1016/j.prp.2009.06.017
A case of true thymic hyperplasia (TTH) associated with thymic hemorrhage (TH) was observed in a 22-year-old male patient who presented with persistent cough and thoracic pain due to an anterior mediastinal mass. The diagnosis of TTH was supported by the observation that the mediastinal mass was essentially composed of histologically normal thymic lobules with preserved cortico-medullary differentiation. The TTH tissue presented multiple areas of hemorrhage associated with the presence of large, tortuous, abnormal vessels in the thymic stroma. Foci of spindle cell proliferations resembling an epitheliod hemangioma were also seen. This finding raises the possibility that vascular malformations, perhaps due to an abnormal growth of the thymus, may be responsible for some cases of TH associated with TTH.
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ABSTRACT: Intense exercise requires a significant increase in cardiac output in order to meet the needs of the skeletal muscles for oxygenated blood. In order to improve cardiac performance, the autonomic nervous system increases sympathetic tone primarily through release of norepinephrine from postganglionic receptors to stimulate the β-adrenergic receptors of the nodal and muscle tissue of the heart. This event initiates a signaling cascade focused on increasing the amount of calcium available to the contractile myofilaments in the cardiac cell. Failure of the myocytes to counterbalance the increase in inward ion flow or adequately sequester cytosolic calcium during diastole leads to potentially catastrophic electrical instability. In this review, the relationship between the cellular events initiated by exercise and the induction of arrhythmias associated with the long QT, Brugada, and Wolff-Parkinson-White syndromes; catecholaminergic polymorphic ventricular tachycardia; and the heritable cardiomyopathies are explored.
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