Isolated nodular thymic amyloidosis associated with diplopia

Area of Science:

• Medical Science
• Oncology
• Pathology

Background:

• A case study of an 85-year-old male presenting with diplopia and a progressively enlarging anterior mediastinal mass.
• Initial assessment included computed tomographic (CT) chest imaging, revealing an irregular, calcified mass suggestive of thymoma.

Observation:

• Video-assisted thoracoscopic thymectomy was performed due to suspected thymoma.
• Histopathological examination of the resected thymic tissue showed deposition of eosinophilic and hyalinized material around blood vessels.

Findings:

• Immunohistochemical staining was positive for anti-λ antibody, confirming localized AL amyloidosis.
• The patient had no signs of systemic amyloidosis or other organ dysfunction.
• Diplopia resolved immediately post-thymectomy.

Implications:

• This case highlights a rare presentation of localized AL amyloidosis within thymic tissue.
• The immediate resolution of diplopia suggests a potential, albeit uncertain, link between the amyloidoma and visual disturbance.
• Further research is needed to elucidate the precise relationship between thymic amyloidosis and neurological symptoms like diplopia.