以皮肌炎为首发症状的胸腺瘤一例

61岁男性患者,面部红斑6个月、加重泛发四肢伴四肢肌肉酸痛3个月。双上肢肌力Ⅳ级,双下肢肌力Ⅳ级。皮肤科情况:双眼睑水肿性紫红斑,全身泛发水肿性紫红色鳞屑性斑片,指关节伸侧可见紫红色扁平Gottron疹。胸部计算机断层增强扫描示:前纵隔肿瘤。纵膈肿物切除术后行组织病理检查,结果示前纵隔胸腺瘤(B2型)。诊断:①皮肌炎,②胸腺瘤。

A case of thymoma with dermatomyositis as the primary symptom

A 61-year-old man was referred to our hospital due to generalized violaceous plaques for 6 months, and muscle weaken and sore of extremities for 3 months. Physical examination revealed generalized swelling and purple plaques with hyperpigmentation of the whole body. Swelling violaceous plaques were found all over his eye lids and extensor side of knuckles. Gottron sign was positive. Grading of muscle strength of upper and lower extremities was gradeⅣ. Enhanced chest CT showed prior mediastinal mass with possibility of thymoma. Histopathology confirmed the nature of the mass was thymoma (Type B2). The diagnosis of this case was concurrent dermatomyositis and thymoma.