Last reviewed: November 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • myasthenia gravis
  • muscle weakness
  • facial and upper extremity oedema
  • facial plethora
  • distended veins in the neck, chest, and/or abdominal wall
  • left-arm swelling

Other diagnostic factors

  • cough
  • dyspnoea
  • fever and/or weight loss

Risk factors

  • hx of myasthenia gravis
  • age >45 years

Diagnostic investigations

1st investigations to order

  • chest x-ray
  • chest CT with intravenous contrast
Full details

Investigations to consider

  • chest MRI
  • tissue biopsy
  • acetylcholine receptor antibodies
  • FBC
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor of Clinical Medicine

Perelman Center for Advanced Medicine

University of Pennsylvania

Philadelphia

PA

Disclosures

TE has received consultancy fees from Genentech and Celgene. She is a board member of Wissahickon Hospice. Educational events include an annual thoracic educational series sponsored by Imedex.

Dr Tracey Evans would like to gratefully acknowledge Dr Nicholas Choong, Dr Mario Gasparri, and Dr Cameron Wright, previous contributors to this monograph. NC and MG declare that they have no competing interests. CW is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Professor of Surgery

Division of Cardiothoracic Surgery

Department of Surgery

Indiana University School of Medicine

Indianapolis

IN

Disclosures

KK declares that he has no competing interests.

Assistant Attending Surgeon

Thoracic Service

Memorial Sloan-Kettering Cancer Center

New York

NY

Disclosures

JH is an author of a number of references cited in this monograph.

Associate Professor

Thoracic Surgery

University of Torino

Torino

Italy

Disclosures

ER is an author of a reference cited in this monograph.

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