[Primary and secondary (reactive) thymus hyperplasia in cases of sudden death]

Two post-mortem cases of thymic hyperplasia are studied. The death of patients occurred suddenly, from an acute hypocorticoidism developing in connection with a surgical operation. In the 1st case (a woman of 27) the thymicolymphatic state (TLS) with anomalies of sex organs was observed. A sudden death occurred 2 hours after the operation of colpopoiesis from the pelvic peritoneum. In the 2nd case (a woman of 30) a sudden death occurred at the end of cesarean operation and extraction of two fetuses (the pregnancy was of a normal duration). The patient had hyperprolactinemia and infertility for 8 years and for this reason was treated with parlodel (total dose 780 mg within 4 months). Acute hypocorticoidism in the 1st case was connected with the adrenal hypoplasia characteristic of TLS in which thymic hyperplasia is a manifestation of a congenital immune-endocrine insufficiency. In the 2nd case hypocorticoidism was due to the adrenal atrophy developing apparently as a result of focal sclerosis of the adenohypophysis. Its development may be explained by the disintegration of prolactin-secreting cells resulting from parlodel treatment. Hyperplasia of the thymus in this case is secondary and reflects the degree of adrenal insufficiency.