J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website https://www.neurores.org

Case Report

Volume 11, Number 1-2, April 2021, pages 32-36

Thymic Neoplasm: A Rare Disease With Unusual Neurologic Manifestations

Figures

Figure 1. Muscle biopsy. Severe perifascicular atrophy and necrosis with extensive myophagocytosis and chronic inflammation (hematoxylin and eosin (H&E), × 100).

Figure 2. Spiral chest computed tomography (CT) scan. The arrow on spiral chest CT scan illustrates a solid, lobulated, well defined and homogenous mass in anterior mediastinum with size of 60 × 43 × 90 mm.

Figure 3. Thymoma. (a) Cellular lobulated architecture lay on thick fibrous band (hematoxylin and eosin (H&E), × 40). (b) Predominant lymphocytes and scattered polygonal epithelial cells (H&E, × 400). (c) Pancytokeratin (Panck) highlights diffuse mesh work of tumoral cells (× 400).

Figure 4. Repetitive nerve stimulation (RNS). Slow RNS in trapezius demonstrates more than 10% decrement in compound muscle action potential (CMAP) amplitude.

Table

**Table 1.** EMG Summary
			Spontaneous					MUAP			Recruitment
The needle EMG study showed abnormal spontaneous/insertional activity in R. Tibialis anterior, R. Vastus lateralis, R. Deltoid, R. Biceps brachii. The MUP waveform abnormality was found in R. Vastus lateralis, R. Deltoid, R. Biceps brachii. Abnormal interference pattern was found in R. Vastus lateralis, R. Deltoid, R. Biceps brachii. Amp: amplitude; Dur: duration; Fasc: fasciculations; Fib: fibrillation; H.F.: high frequency; IA: Ia fibers; MUAP: motor unit action potential; N: normal, PPP: polyphasic potential; PSW: polyspike wave; EMG: electromyography.
Muscle	Nerve	Roots	IA	Fib	PSW	Fasc	H.F.	Amp	Dur	PPP	Pattern
R. Tibialis anterior	Deep peroneal (fibular)	L4 - L5	N	2+	2+	None	None	N	N	N	N
R. Vastus lateralis	Femoral	L2 - L4	N	2+	1+	None	None	1-	N	N	1+
R. Deltoid	Axillary	C5 - C6	N	3+	2+	None	None	1-	1-	1+	2+
R. Biceps brachii	Musculocutaneous	C5 - C6	N	2+	2+	None	None	2-	2-	3+	2+