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Medicine Immunology and Rheumatology 5e321a6e

A 30-year-old woman presents to the clinic complaining of fatigue. In addition, she reports that her urine is very dark and "tea color" like, and today her partner commented that her eyes look yellow. Her past medical history is significant for myasthenia gravis for which she is taking azathioprine and pyridostigmine. Laboratory investigations reveal findings in keeping with autoimmune hemolytic anemia. The chest x-ray (CXR) reveals an anterior mediastinal mass. Which of the following is the most likely diagnosis?

A
thymoma
B
nodular sclerosing Hodgkin disease
C
small cleaved cell non-Hodgkin lymphoma
D
teratoma
High-Yield Explanation
Thymic tumors may be associated with myasthenia gravis, red cell aplasia, polymyositis, hemolytic anemia, pemphigus, and agranulocytosis. There is also an association with immunodeficiency and thymoma. These patients have B-lymphocyte deficiency and bacterial infections and diarrhea. Erythroid aplasia may develop as well.

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