A Rare Complication of Thymoma: Pure White Cell Aplasia in Good's Syndrome

Kim Uy, Elizabeth Levin, Pawel Mroz, Faqian Li, Surbhi Shah

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Pure white cell aplasia (PWCA) is a rare manifestation of thymoma. It is characterized by agranulocytosis with absent myeloid precursors in the bone marrow and normal hematopoiesis for other cell lines. Here we describe a 65-year-old female patient who presented with three days of fever and night sweat. Chest CT revealed an anterior mediastinal mass. A biopsy of the mass confirmed a diagnosis of thymoma mixed type A and B2. The patient developed a severe neutropenia, and her bone marrow revealed significantly decreased neutrophil-lineage cells, rare to absent B cells, and defective T cells, consistent with PWCA. Following thymectomy, a complete resolution of PWCA was achieved via multimodality therapy of intravenous immunoglobulins, granulocyte colony-stimulating factor, and immunosuppressant. This report highlights the care complexity regarding treatment choices and decision to perform thymectomy in patients presenting with PWCA.

Original languageEnglish (US)
Pages (from-to)1024670
JournalCase reports in hematology
StatePublished - 2019

Bibliographical note

Copyright © 2019 Kim Uy et al.

PubMed: MeSH publication types

  • Case Reports

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