Mediastinum - Acute thymic involution

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Mediastinum

Thymus

Acute thymic involution

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 22 February 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Due to stress (chronic debilitating disease), HIV or other infections, prolonged protein malnutrition and immunosuppressive or cytotoxic drugs, graft versus host reaction
● Seen in newborn infants with chorioamnionitis and sepsis
● Thymus size is significantly reduced in preterm infants born to mothers with subclinical, histologically proven chorioamnionitis (Hum Pathol 2000;31:1121)

Micro description
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● Preservation of lobular architecture and Hassall’s corpuscles, but marked lymphocyte depletion (particularly with HIV)
● Vessels are large compared to size of lobules
● Frequent plasma cells, fibrohyaline changes of basement membrane of vessels and thymic epithelium
● HIV patients also have effacement of corticomedullary junction and inconspicuous Hassall’s corpuscles

Micro images
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Due to sepsis

Differential diagnosis
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● Thymic hyperplasia
● Thymic dysplasia

End of Mediastinum > Thymus > Acute thymic involution

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