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{{Thymoma}}
{{Thymoma}}
{{CMG}}; {{AE}} {{AM}}{{AAM}}
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==Overview==


Patients with thymoma usually appear asymptomatic.
== Overview ==
 
[[Patient|Patients]] with thymoma usually appear [[asymptomatic]]. [[Physical examination]] of [[Patient|patients]] with thymoma may be remarkable for [[neck]] [[lump]], [[facial]] [[swelling]], and [[wheezing]].
== Physical Examination ==
 
=== Appearance of the Patient ===
 
*[[Patient|Patients]] usually appear well.
=== Vital Signs ===
 
* [[Vital signs]] of [[Patient|patients]] with thymoma are usually normal.
 
=== Skin ===
 
*[[Malar rash]] may be present (suggestive of [[SLE|systemic lupus erythrematouses]]).
 
=== HEENT ===
 
*[[Facial]] [[swelling]] may be present.
 
=== Neck ===
 
* [[Neck]] [[lump]] may be present.
 
=== Lungs ===
 
* [[Wheezing]] may be present.
*Dullness on [[percussion]] of the [[Anatomical terms of location|anterior]] [[chest]].
 
=== Heart ===
 
* [[Circulatory system|Cardiovascular]] [[Physical examination|examination]] of [[Patient|patients]] with thymoma is usually normal.


==Physical Examination==
=== Abdomen ===
The physical examination plays a limited role in the diagnosis of thymoma, Physical exam findings maybe  but it is very important to check general signs of health and signs of many of the paraneoplastic syndromes and that are present in a considerable percentage of patients, as lumps and anything else that seems unusual. Some patients with different thymic tumors will have fullness in the lower part of the neck which the doctor can feel.
Once Thymoma or any other thymic tumor is suspected based on physical examination, further investigations as x-ray, CT and other lab tests should be done.


==Physical Examination of Myasthenia Gravis==
* [[Abdominal examination]] of [[Patient|patients]] with thymoma is usually normal.
'''Myasthenia gravis is associated with 15% of patients with thymoma.'''
 
Muscle fatigability can be tested for many muscles. A thorough examination demonstrates easy fatigability during following movements:
=== Back ===
* Looking upward and sidewards for 30 seconds: [[ptosis (eyelid)|ptosis]] and [[diplopia]].
 
* Looking at the feet while lying on the back for 60 seconds
* [[Human back|Back]] [[Physical examination|examination]] of [[Patient|patients]] with thymoma is usually normal.
* Keeping the arms stretched forward for 60 seconds
 
* 10 deep knee bends
=== Genitourinary ===
* Walking 30 steps on both the toes and the heels
 
* 5 situps, lying down and sitting up completely
* [[Genitourinary system|Genitourinary]] [[Physical examination|examination]] of [[Patient|patients]] with thymoma is usually normal.
 
=== Neuromuscular ===
 
* [[Muscle weakness]] may be present (suggestive of [[myasthenia gravis]])<ref name="pmid28278141">{{cite journal| author=Qi G, Liu P, Dong H, Gu S, Yang H, Xue Y| title=Metastatic Thymoma-Associated Myasthenia Gravis: Favorable Response to Steroid Pulse Therapy Plus Immunosuppressive Agent. | journal=Med Sci Monit | year= 2017 | volume= 23 | issue=  | pages= 1217-1223 | pmid=28278141 | doi= | pmc=5356615 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28278141  }} </ref>
 
=== Extremities ===
 
* [[Joint]] deformity may be present (suggestive of an associated [[joint]] [[disease]])


==References==
==References==
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Latest revision as of 19:43, 14 August 2019


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]Ahmad Al Maradni, M.D. [3]

Overview

Patients with thymoma usually appear asymptomatic. Physical examination of patients with thymoma may be remarkable for neck lump, facial swelling, and wheezing.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

References

  1. Qi G, Liu P, Dong H, Gu S, Yang H, Xue Y (2017). "Metastatic Thymoma-Associated Myasthenia Gravis: Favorable Response to Steroid Pulse Therapy Plus Immunosuppressive Agent". Med Sci Monit. 23: 1217–1223. PMC 5356615. PMID 28278141.

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