Thymus in myasthenia gravis: a light and electron microscopic study of a case with thymic follicular hyperplasia

The present study has focused mainly on microenvironmental aspects of the thymus from a 17-year-old female patient suffering from myasthenia gravis. The most striking lightmicroscopic feature was again the well known presence of lymphoid follicular hyperplasia. Ultrastructurally, the configuration, cellular composition and fine structure were to a large extent the same as in other, peripheral lymphoid organs. Cells showing the typical morphologic characteristics of fibroblastic reticulum cells, which are most probably precursors of dendritic reticulum cells, were observed within germinal centers. Additionally the morphology of the unaffected medulla and corticomedullary region was studied, thereby paying particular attention to the structural changes of interdigitating cells. These contained frequently Birbeck granules, which have not been described before in human thymus.