Radiologic changes in the thymoma-hypogammaglobulinemia syndrome

Radiologic findings in the thymoma-hypogammaglobulinemia syndrome are encountered in three stages reflecting the natural history of the syndrome. Initially, a mediastinal mass is apparent on chest x-ray in an asymptomataic patient. At this stage a failing immune system has apparently induced compensatory thymic hyperplasia which progresses to frank neoplasia. In 55% of the cases this thymic tumor is paracardiac in location. With progressive failure of immunoglobulin production, acute and chronic pulmonary infiltrates occur secondary to infection. Markedly, decreased IgA in the bowel may eventually be manifested by radiologic changes of exudative enteropathy.