The thymus role has been unclear until the second half of 1900. Nowadays its function is much clearer, and the increase of the thymus pathology is a challenging problem that can be better faced. The most important thymus diseases often require a multidisciplinary approach, and involve several specialists, from the clinical immunologist to the neurologist and the radiologist, from the surgeon to the anaesthesist and the oncologist. The volume deals with the whole range of this gland pathology and describes the most recent surgical and non surgical techniques. Written by international experts, it will be very useful for all those involved in the treatment of these diseases.
Author(s): Corrado Lavini, Cesar A. Moran, Uliano Morandi, Rudolf Schoenhuber
Edition: 1
Publisher: Springer
Year: 2008
Language: English
Pages: 274
Preface......Page 6
Contents......Page 8
Contributors......Page 11
The Thymus from Antiquity to the Present Day: the History of a Mysterious Gland......Page 16
References......Page 26
Gross Anatomy......Page 28
Microscopic Structure......Page 29
Innervation......Page 31
Thymus in Postnatal Life......Page 32
References......Page 33
Immune Functions of the Thymus......Page 34
Endocrine Functions of the Thymus......Page 38
References......Page 40
Congenital Malformations of the Thymus......Page 46
References......Page 51
True Thymic Hyperplasia......Page 53
Follicular Thymic Hyperplasia (So-called Thymitis)......Page 59
Thymic Changes in Infectious Diseases......Page 61
References......Page 63
Benign Tumors......Page 68
Malignant Tumors......Page 71
References......Page 77
Clinical Features Due to Congenital Pathology of Thymus......Page 81
Clinical Features of Thymic Aplasia (DiGeorge Syndrome) (DGS)......Page 82
Clinical Features Due to Epithelial Tumors of Thymus......Page 86
Clinical Features Due to Neuroendocrine Tumors of Thymus......Page 92
Role of the Thymus in Immune Reconstitution in HIV Infection......Page 94
References......Page 95
The Pathophysiology of Myasthenia Gravis......Page 100
Clinical Course of MG......Page 104
Principles of Diagnostic Testing for MG......Page 106
Associated Conditions......Page 107
References......Page 108
The Normal Thymus......Page 110
The Diseased Thymus......Page 111
References......Page 118
Differentiation of Normal and Hyperplastic Thymus from Malignant Involvement......Page 121
References......Page 129
Diagnostic Techniques......Page 131
Conclusions......Page 139
References......Page 140
General Anatomical Points......Page 143
Anterior and Posterior Relations of the Body of the Gland......Page 144
References......Page 146
Preoperative Period......Page 147
Intraoperative Period......Page 150
Postoperative Period......Page 154
References......Page 156
Indications......Page 158
The Operation......Page 159
Conclusions......Page 161
References......Page 162
Technique......Page 165
Conclusions......Page 166
References......Page 167
Surgical Indications......Page 169
Transthoracic Approach: Indications and Surgical Technique......Page 170
Conclusions......Page 173
References......Page 174
Perioperative Management......Page 175
Video-assisted Transcervical Approach......Page 176
References......Page 178
Patients and Methods......Page 180
Results......Page 182
Discussion......Page 183
References......Page 185
Surgical Technique......Page 187
Results......Page 190
References......Page 192
Techniques for Video-assisted Thoracoscopic Extended Thymectomy......Page 193
Results......Page 196
References......Page 197
Left sided Thoracoscopic Thymectomy......Page 198
Own Results......Page 200
Discussion......Page 201
References......Page 203
Indications......Page 205
Arm Position......Page 206
Anatomy......Page 207
Extraction......Page 208
Results of VATS Thymectomy......Page 209
References......Page 210
Description of the fiDaVincif Robotic System......Page 211
Operative Technique......Page 212
Conclusions......Page 214
References......Page 215
Diagnosis......Page 216
Management......Page 217
References......Page 219
State of the Art......Page 220
Our Experience......Page 222
Results......Page 224
Case Reports......Page 225
References......Page 226
Locally Advanced Disease......Page 228
Recurrent Disease......Page 229
References......Page 230
Stage I......Page 232
Stage II......Page 233
Stage III......Page 235
Neoadjuvant Radiation Therapy......Page 236
Radiotherapy Techniques......Page 237
Radiation Treatment Results......Page 238
References......Page 240
Role of Steroids in the Treatment of Thymic Neoplasms......Page 243
Role of Somatostatin-based Therapy in Thymic Neoplasms......Page 244
References......Page 247
Introduction......Page 249
Treatment of Patients with Clinical Signs and Symptoms of MG......Page 250
A Practical Approach to the Management of MG Patients......Page 254
References......Page 256
Patient Population......Page 257
Screening of Recipients for Transplantation......Page 258
Tissue Processing and Tissue Screening for Thymus Transplantation......Page 259
Preparation of the Recipient for Transplantation......Page 260
Clinical Outcomes......Page 261
Immune Outcomes......Page 263
Summary......Page 266
References......Page 267
Subject Index......Page 270
