PMC10063851_01
(A) Sagittal reconstruction contrast enhanced computed tomography image of the thorax showing the thymoma (green arrows). (B) Transverse contrast enhanced computed tomography image of the thorax showing the thymoma (green arrows). (C) Dorsal reconstruction contrast enhanced computed tomography image of the thorax showing the thymoma (green arrows). (D) Transverse contrast enhanced computed tomography image of the abdomen showing the cholangiocellular carcinoma (blue arrows). (E) Dorsal reconstruction contrast enhanced computed tomography image of the abdomen showing the cholangiocellular carcinoma (blue arrows).
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F1
A single large rounded well-defined smoothly marginated soft tissue attenuating mass was identified in the cranial mediastinum with heterogeneous contrast enhancement (Figure 1). No other abnormalities were detected upon thoracic imaging (Figure 1). Abdominal CT studies identified a single large rounded well-defined smoothly marginated hypoattenuating mass with mild contrast enhancement in the right lateral liver lobe (Figure 1).
Serum acetylcholine receptor antibody concentration and pyridostigmine bromide dosage over time.
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F2
At this time, the serum AChR antibody concentration result was reported as 1.95 nmol/l (day 0 concentration) (Figure 2), consistent with MG (normal < 0.6 nmol/l). Measurement of serum AChR antibody concentration was repeated and had increased to 6.99 nmol/l (day 35 concentration) (Figure 2). Serum AChR antibody concentration was measured and was 3.9 nmol/l (day 128 concentration) (Figure 2). Serum AChR antibody concentration was 0.99 nmol/l (Figure 2). The examination remained normal with a serum AChR antibody concentration of 2.03, 1.05, and 0.15 nmol/l respectively, indicating immune remission had been achieved (Figure 2).