小结
定义
病史和体格检查
关键诊断因素
- 重症肌无力
- 肌无力
- 面部和上肢水肿
- 面部充血
- 颈部、胸壁和/或腹壁的静脉扩张
- 左臂肿胀
其他诊断因素
- 咳嗽
- 呼吸困难
- 发热和/或体重减轻
危险因素
- 重症肌无力病史
- 45 岁以上
诊断性检查
首要检查
- 胸部 X 线检查
- 胸部增强 CT
需考虑的检查
- 胸部 MRI
- 组织活检
- 乙酰胆碱受体抗体
- 全血细胞计数（FBC）
- PET/CT 扫描
- 血清甲胎蛋白
- 血清 β-人绒毛膜促性腺激素（beta-hCG）
治疗流程
可切除的肿瘤
局部晚期肿瘤
复发性肿瘤
撰稿人
作者
Douglas Z. Liou, MD
Clinical Assistant Professor of Cardiothoracic Surgery
Division of Thoracic Surgery
Stanford University School of Medicine / Stanford Cancer Institute
Stanford
CA
利益声明
DZL declares that he has no competing interests.
Joseph B. Shrager, MD
Professor of Cardiothoracic Surgery
Chief, Division of Thoracic Surgery
Medical Director, Thoracic Oncology CCP
Stanford University School of Medicine / Stanford Cancer Institute
Stanford
CA
利益声明
JBS declares that he has no competing interests.
鸣谢
Dr Douglas Z. Liou and Dr Joseph B. Shrager would like to gratefully acknowledge Dr Tracey Evans, Dr Nicholas Choong, Dr Mario Gasparri, and Dr Cameron Wright, previous contributors to this topic.
利益声明
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. NC and MG declare that they have no competing interests. CW is an author of a number of references cited in this topic.
同行评议者
Enrico Ruffini, MD
Associate Professor
Thoracic Surgery
University of Torino
Torino
Italy
利益声明
ER is an author of a reference cited in this topic.
James R. Jett, MD
Emeritus Professor of Medicine
National Jewish Health
Denver
CO
利益声明
JRJ is co-editor of the section on thymoma in Up To Date. He is also co-chief medical officer for Biodesix Inc.
鉴别诊断
- 淋巴瘤
- 恶性纵隔生殖细胞肿瘤：精原细胞瘤
- 恶性纵隔生殖细胞肿瘤：非精原细胞瘤
更多 鉴别诊断指南
- NCCN 肿瘤学临床实践指南：胸腺瘤和胸腺癌
- 胸腺上皮肿瘤患者的手术、放射和全身治疗
更多 指南
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