Computed tomography of the anterior mediastinum in myasthenia gravis. A radiologic-pathologic correlative study.

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Abstract
Chest radiographs and computed tomographic (CT) scans of the mediastinum were correlated with pathologic findings of the thymus following thymectomy in 57 patients with myasthenia gravis. Based on the patient''s age and the overall morphology of the anterior mediastinum, CT scans were assigned 1 of 4 grades to predict thymus pathologic findings. Using this grading, 14 of 16 cases of thymoma were suspected or definitely diagnosed. One of the 2 cases not diagnosed on CT was a microscopic tumor. There were no false-positive diagnoses in 11 cases graded as definitely thymoma. Thymoma evidently can be sensitively diagnosed in patients older than 40 yr of age. Thymoma cannot be predicted with a high level of confidence in patients younger than 40 because of the difficulty in differentiating normal thymus or hyperplasia from thymoma. Recommendations for the use of CT in the preoperative evaluation of myasthenic patients are presented.

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