Thymic involvement in myasthenia gravis. Study by immunofluorescent and immunoperoxidase staining

Changes in the thymus are often encountered in myasthenia gravis (MG), together with neuromuscular pathology. In the present study, the cell population of 28 thymuses from patients with MG were analyzed by immunofluorescent and 49 thymuses by immunoperoxidase techniques. We were able to show the presence of sIg receptor positive, SpA reactive medium and large B lymphocytes of light specific density in the majority of thymuses, and to demonstrate a characteristic pattern of distribution in the gland. PAP analysis showed that the infiltrating B cells appeared in the interlobular septa, then reached the medulla, occasionally the cortex which mostly revealed signs of atrophy. These findings are consistent with an autoimmune reaction occurring against a thymic antigen; such an antigen could be acetylcholine receptor (AchR) of the thymic structures, since anti-AchR antibody or serum from patients with MG will react with 60% thymocytes and some epithelial cells and Hassall's corpuscles.