Enlargement of the thymus in adults. What is the thymus gland (thymus)? Functions for which it is responsible. What is iron responsible for in children

Content

People don't know everything about their body. Where the heart, stomach, brain and liver are located is known to many, and the location of the pituitary gland, hypothalamus or thymus is not known to many. However, the thymus or thymus gland is a central organ and is located in the very center of the sternum.

Thymus gland - what is it

Iron got its name due to the shape resembling a two-pronged fork. However, a healthy thymus looks like this, and a sick one takes on the appearance of a sail or a butterfly. For its proximity to the thyroid gland, doctors used to call it the thymus gland. What is thymus? This is the main organ of vertebrate immunity, in which the production, development and training of T-cells of the immune system takes place. The gland begins to grow in a newborn baby before the age of 10, and after the 18th birthday it gradually decreases. The thymus is one of the main organs for the formation and activity of the immune system.

Where is the thymus located

The thymus can be identified by placing two folded fingers on the top of the sternum below the clavicular notch. The location of the thymus is the same in children and adults, but the anatomy of the organ has age-related features. At the time of birth, the weight of the thymus organ of the immune system is 12 grams, and by puberty it reaches 35-40 g. Atrophy begins at about 15-16 years. By the age of 25, the thymus weighs about 25 grams, and by 60 it weighs less than 15 grams.

By the age of 80, the weight of the thymus gland is only 6 grams. The thymus by this time becomes elongated, the lower and lateral parts of the organ atrophy, which are replaced by adipose tissue. This phenomenon is not explained by official science. Today it is the biggest mystery of biology. It is believed that opening this veil will allow people to challenge the aging process.

The structure of the thymus

We have already found out where the thymus is located. The structure of the thymus gland will be considered separately. This small-sized organ has a pinkish-gray color, soft texture, and a lobed structure. The two lobes of the thymus are completely fused or closely adjacent to each other. The upper part of the body is wide, and the lower one is narrower. The entire thymus gland is covered with a capsule of connective tissue, under which there are dividing T-lymphoblasts. The jumpers that depart from it divide the thymus into lobules.

The blood supply to the lobular surface of the gland comes from the internal mammary artery, thymic branches of the aorta, branches of the thyroid arteries and the brachiocephalic trunk. Venous outflow of blood is carried out through the internal thoracic arteries and branches of the brachiocephalic veins. In the tissues of the thymus, the growth of various blood cells occurs. The lobular structure of the organ contains cortex and medulla. The first looks like a dark substance and is located on the periphery. Also, the cortical substance of the thymus gland contains:

hematopoietic cells of the lymphoid series, where T-lymphocytes mature;
hematopoietic macrophage series, which contain dendritic cells, interdigitating cells, typical macrophages;
epithelial cells;
supporting cells that form the hemato-thymic barrier, which form the tissue framework;
stellate cells - secreting hormones that regulate the development of T-cells;
baby-sitter cells in which lymphocytes develop.

In addition, the thymus secretes the following substances into the bloodstream:

thymic humoral factor;
insulin-like growth factor-1 (IGF-1);
thymopoietin;
thymosin;
thymalin.

What is responsible for

Thymus in a child forms all the systems of the body, and in an adult it maintains good immunity. What is the thymus responsible for in the human body? The thymus gland performs three important functions: lymphopoietic, endocrine, immunoregulatory. It produces T-lymphocytes, which are the main regulators of the immune system, that is, the thymus kills aggressive cells. In addition to this function, it filters the blood, monitors the outflow of lymph. If any malfunction occurs in the work of the organ, then this leads to the formation of oncological and autoimmune pathologies.

In children

In a child, the formation of the thymus begins at the sixth week of pregnancy. The thymus gland in children under one year old is responsible for the production of T-lymphocytes by the bone marrow, which protect the child's body from bacteria, infections, and viruses. An enlarged goiter (hyperfunction) in a child does not affect health in the best way, as it leads to a decrease in immunity. Children with this diagnosis are susceptible to various allergic manifestations, viral and infectious diseases.

In adults

The thymus gland begins to involute with age, so it is important to maintain its functions in a timely manner. Thymus rejuvenation is possible with a low-calorie diet, taking Ghrelin, and using other methods. The thymus gland in adults is involved in modeling two types of immunity: a cell-type response and a humoral response. The first forms the rejection of foreign elements, and the second manifests itself in the production of antibodies.

Hormones and functions

The main polypeptides produced by the thymus gland are thymalin, thymopoietin, thymosin. By their nature, they are proteins. When lymphoid tissue develops, lymphocytes get the opportunity to take part in immunological processes. Thymus hormones and their functions have a regulatory effect on all physiological processes in the human body:

reduce cardiac output and heart rate;
slow down the work of the central nervous system;
replenish energy reserves;
accelerate the breakdown of glucose;
increase the growth of cells and skeletal tissue due to increased protein synthesis;
improve the work of the pituitary gland, thyroid gland;
produce the exchange of vitamins, fats, carbohydrates, proteins, minerals.

Hormones

Under the influence of thymosin, lymphocytes are formed in the thymus, then, with the help of the influence of thymopoietin, blood cells partially change their structure to ensure maximum protection of the body. Timulin activates T-helpers and T-killers, increases the intensity of phagocytosis, accelerates regeneration processes. Thymus hormones are involved in the work of the adrenal glands and genital organs. Estrogens activate the production of polypeptides, while progesterone and androgens inhibit the process. A glucocorticoid, which is produced by the adrenal cortex, has a similar effect.

Functions

In the tissues of the goiter, blood cells proliferate, which enhances the immune response of the body. The resulting T-lymphocytes enter the lymph, then colonize in the spleen and lymph nodes. Under stressful influences (hypothermia, starvation, severe trauma, and others), the functions of the thymus gland weaken due to the massive death of T-lymphocytes. After that, they undergo positive selection, then negative selection of lymphocytes, then regenerate. The functions of the thymus begin to fade by the age of 18, and fade almost completely by the age of 30.

Thymus gland diseases

As practice shows, diseases of the thymus are rare, but always accompanied by characteristic symptoms. The main manifestations include severe weakness, an increase in lymph nodes, a decrease in the protective functions of the body. Under the influence of developing diseases of the thymus, lymphoid tissue grows, tumors are formed that cause swelling of the limbs, compression of the trachea, borderline sympathetic trunk or vagus nerve. Malfunctions in the work of the body are manifested with a decrease in function (hypofunction) or with an increase in the work of the thymus (hyperfunction).

magnification

If the ultrasound photo showed that the central organ of lymphopoiesis is enlarged, then the patient has thymus hyperfunction. Pathology leads to the formation of autoimmune diseases (lupus erythematosus, rheumatoid arthritis, scleroderma, myasthenia gravis). Hyperplasia of the thymus in infants is manifested in the following symptoms:

decrease in muscle tone;
frequent regurgitation;
weight problems;
heart rhythm failures;
pale skin;
profuse sweating;
enlarged adenoids, lymph nodes, tonsils.

hypoplasia

The central organ of human lymphopoiesis may have congenital or primary aplasia (hypofunction), which is characterized by the absence or weak development of the thymic parenchyma. Combined immunological deficiency is diagnosed as a congenital disease of Dee George, in which children have heart defects, convulsions, anomalies of the facial skeleton. Hypofunction or hypoplasia of the thymus gland can develop against the background of diabetes mellitus, viral diseases, or alcohol consumption by a woman during pregnancy.

Tumor

Thymomas (tumors of the thymus) occur at any age, but more often such pathologies affect people from 40 to 60 years old. The causes of the disease have not been established, but it is believed that a malignant tumor of the thymus arises from epithelial cells. It has been observed that this phenomenon occurs if a person suffered from chronic inflammation or viral infections or was exposed to ionizing radiation. Depending on which cells are involved in the pathological process, the following types of tumors of the goiter gland are distinguished:

spindle cell;
granulomatous;
epidermoid;
lymphoepithelial.

Symptoms of thymus disease

When the work of the thymus changes, an adult feels a violation of breathing, heaviness in the eyelids, muscle fatigue. The first signs of thymus disease are a long recovery after the simplest infectious diseases. In violation of cellular immunity, symptoms of a developing disease begin to appear, for example, multiple sclerosis, Basedow's disease. With any decrease in immunity and the corresponding signs, you should immediately contact the doctor.

Thymus gland - how to check

If a child has frequent colds that turn into severe pathologies, there is a greater predisposition to allergic processes, or lymph nodes are enlarged, then a diagnosis of the thymus gland is needed. For this purpose, a sensitive high-resolution ultrasound machine is needed, since the thymus is located near the pulmonary trunk and atrium, and is closed by the sternum.

In case of suspicion of hyperplasia or aplasia, after a histological examination, the doctor may refer you to computed tomography and examination by an endocrinologist. The tomograph will help to establish the following pathologies of the thymus gland:

MEDAC syndrome;
DiGeorge syndrome;
myasthenia gravis;
thymoma;
T-cell lymphoma;
pre-T-lymphoblastic tumor;
neuroendocrine tumor.

Norms

In a newborn baby, the size of the thymus gland is on average 3 cm wide, 4 cm long and 2 cm thick. The average size of the thymus is normally presented in the table:

	Width (cm)	Length (cm)	Thickness (cm)
1-3 months
10 months - 1 year

Pathology of the thymus

In violation of immunogenesis, changes in the gland are observed, which are represented by such diseases as dysplasia, aplasia, accidental involution, atrophy, hyperplasia with lymphoid follicles, thymomegaly. Often, thymus pathology is associated either with an endocrine disorder, or with the presence of an autoimmune or oncological disease. The most common cause of a decline in cellular immunity is age-related involution, in which there is a deficiency of melatonin in the pineal gland.

How to treat the thymus

As a rule, thymus pathologies are observed up to 6 years. Then they disappear or turn into more serious diseases. If the child has an enlarged goiter gland, then a phthisiatrician, immunologist, pediatrician, endocrinologist and otolaryngologist should be observed. Parents should monitor the prevention of respiratory diseases. If symptoms such as bradycardia, weakness and/or apathy are present, urgent medical attention is required. Treatment of the thymus gland in children and adults is carried out by medical or surgical methods.

Medical treatment

When the immune system is weakened, to maintain the body, it requires the introduction of biologically active substances. These are the so-called immunomodulators that thymus therapy offers. Treatment of the goiter gland in most cases is carried out on an outpatient basis and consists of 15-20 injections that are injected into the gluteal muscle. The treatment regimen for thymus pathologies may vary, depending on the clinical picture. In the presence of chronic diseases, therapy can be carried out for 2-3 months, 2 injections per week.

Intramuscularly or subcutaneously, 5 ml of thymus extract isolated from the peptides of the goiter gland of animals is injected. It is a natural biological raw material without preservatives and additives. Already after 2 weeks, improvements in the general condition of the patient are noticeable, since protective blood cells are activated during the treatment. Thymus therapy has a long-term effect on the body after the therapy. A second course can be carried out after 4-6 months.

Operation

Thymectomy or removal of the thymus is indicated if the gland has a tumor (thymoma). The operation is performed under general anesthesia, which keeps the patient asleep during the entire operation. There are three types of thymectomy:

Transsternal. An incision is made in the skin, after which the sternum is separated. The thymus is separated from the tissues and removed. The incision is closed with staples or sutures.
Transcervical. An incision is made along the lower part of the neck, after which the gland is removed.
Video assisted surgery. Several small incisions are made in the upper mediastinum. A camera is inserted through one of them, displaying the image on the monitor in the operating room. During the operation, robotic arms are used, which are inserted into the incisions.

diet therapy

Diet therapy plays an important role in the treatment of thymus pathologies. Foods rich in vitamin D should be introduced into the diet: egg yolk, brewer's yeast, dairy products, fish oil. The use of walnut, beef, liver is recommended. When developing a diet, doctors advise including in the diet:

parsley;
broccoli, cauliflower;
oranges, lemons;
sea buckthorn;
syrup or decoction of wild rose.

Alternative treatment

Children's doctor Komarovsky advises to warm up the thymus with a special massage to increase immunity. If an adult has an unreduced gland, then he should maintain immunity for prevention by taking herbal preparations with rose hips, black currants, raspberries, and lingonberries. Treatment of the thymus with folk remedies is not recommended, since the pathology requires strict medical supervision.

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Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

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V. L. Manevich, V. D. Stonogin, T. N. Shirshova, I. V. Shuplov, S. V. Momotiuk

II Department of Clinical Surgery (Head - Professor Timofei Pavlovich Makarenko) of the Central Institute for the Improvement of Doctors on the basis of the Central Clinical Hospital No. 1MPS.

The publication is dedicated to the memory of Vasily Dmitrievich Stonogin (1933-2005)

Thymus diseases are studied by doctors of various specialties: neuropathologists, endocrinologists, immunologists, hematologists, surgeons, pathologists, etc. The problem of myasthenia gravis is relatively well studied; in recent years, the involvement of the thymus gland in such a vital process as the development (regulation) of immunity has been established.

Tumors and cysts of the thymus, myasthenia gravis and some autoimmune diseases require surgical treatment. A significant contribution to this complex section was made by domestic and foreign surgeons (A. N. Bakulev and R. S. Kolesnikova; V. R. Braitsev; B. K. Osipov; B. V. Petrovsky; M. I. Kuzin et al. ; S. A. Gadzhiev and V. Vasiliev; Viets, etc.).

From 1966 to 1973, we observed 105 patients with various diseases of the anterior mediastinum, 66 of them with various diseases of the thymus. These patients were divided into the following clinical groups: 1st - 30 patients with thymus hyperplasia and myasthenia gravis; 2nd - 23 patients with tumors of the thymus gland (thymomas), of which 15 were benign, including 9 with myasthenia gravis; with malignant 8, including myasthenia gravis 5; 3rd - 4 patients with thymus cysts, all without myasthenia gravis; 4th - 3 patients with teratoid formations; 13th - 2 patients - Hodgkin's disease with an isolated lesion of the thymus; 6th - 4 patients with aplastic anemia against the background of autoimmune aggression of the thymus gland.

Of the 66 patients, 65 were operated on: 62 radical and 3 exploratory surgery.

Under our supervision, there were 44 patients with myasthenia gravis, of which 43 (13 men and 30 women) were operated on; the age of the operated patients was from 14 to 55 years, and the age of the majority (25 patients) was from 15 to 30 years. Among patients with tumors of the thymus, 30-40-year-olds (13 patients) predominated.

Myasthenia gravis is a complex neuroendocrine disease, the main manifestation of which is weakness and especially rapid, pathological muscle fatigue after exercise. Along with this, according to the studies of a number of authors (M.I. Kuzin et al., etc.), with myasthenia gravis, the function of many organs and systems (cardiovascular, respiratory, digestive, metabolism, etc.) is disrupted. .

The clinic of myasthenia is well known, however, the correct diagnosis of a patient with myasthenia is often made after a long observation. In 32 of our 44 patients, the correct diagnosis was made only 6-8 months after the first signs of the disease appeared. This is explained by the low severity of the clinical picture of myasthenia gravis in the initial stage and the poor awareness of practitioners who are first contacted for help by patients with myasthenia gravis (neuropathologists, ophthalmologists, otolaryngologists, therapists).

With a pronounced generalized form of myasthenia gravis, the diagnosis is not difficult. In the initial stage and in cases where myasthenia is localized (bulbar, ocular, musculoskeletal, pharyngeal-facial), our patients assumed a variety of diagnoses, up to suspicion of simulation. We consider it necessary to emphasize the special importance of the proserine test, which has a differential diagnostic value. In patients with myasthenia gravis, an intramuscular injection of 1-2 ml of a 0.05% solution of prozerin eliminates muscle weakness and fatigue, while with myopathies and muscle weakness caused by other causes, the injection of prozerin has no effect. Dynamometry, ergometry and electromyography matter.

It is generally accepted that the treatment of myasthenia gravis should be carried out in a complex manner with the participation of 3-4 specialists: a neuropathologist, an endocrinologist, an anesthesiologist-resuscitator and a surgeon. On the basis of a large clinical material (hundreds of those operated on and observed in the long-term period), the authors emphasize the advantage of surgical treatment of myasthenia gravis over conservative (M. I. Kuzin; A. S. Gadzhiev et al., etc.). The results of surgical treatment are better if the operation is performed for the first time 2-2.5 years from the onset of the disease. At a later date, the operation is less effective. Hence the particular importance of early diagnosis of myasthenia gravis.

Of the 43 patients operated on by us in the first year of myasthenia gravis, only 12 were admitted, in the period from 1 to 3 years - 23, and after 3 years - 8 patients. Consequently, patients were admitted to the clinic for surgical treatment late.

A special method for examining the thymus is radiopaque - pneumomediastinography, which allows one to judge the degree of enlargement of the thymus, its structure - a separate node with clearly defined contours or a tumor with infiltrating growth, etc.

The presence of a pronounced clinical picture of progressive myasthenia gravis in a patient is an indication for surgery, since all conservative methods of treatment, including X-ray therapy, give only a temporary improvement.

In patients with myasthenia gravis, special preoperative preparation is necessary, the purpose of which is to reduce the manifestations of myasthenia gravis by individual selection of the dose of drugs. Dosages of drugs are selected strictly individually, so that during the day there are no periods of myasthenic exhaustion, no myasthenic crisis occurs. Preoperative preparation, being a symptomatic therapy, has some therapeutic effect, which is positive for the upcoming operation. However, not all patients preoperative preparation, despite its complexity and intensity, is effective.

The question of the need for preoperative radiotherapy cannot be considered definitively resolved. Only 5 of our patients received X-ray irradiation before the operation, and we did not notice any improvements during the postoperative period. In patients operated on for malignant thymoma with myasthenia gravis, preoperative irradiation plays an important role in the immediate outcome of the operation and to some extent affects the timing of the onset of disease recurrence (MI Kuzin et al.).

Most operations for myasthenia gravis were performed by us from the anterior approach by complete median longitudinal sternotomy. The most crucial moment of the operation is the separation of the gland from the left brachiocephalic vein. Injury to this vessel is dangerous due to massive bleeding and possible air embolism. In one case, this vein was injured, which ended successfully (a lateral vascular suture was applied). During the operation, the imposition of clamps on the glandular tissue, crushing it should be avoided.

3 of our patients had a combination of myasthenia gravis and retrosternal goiter. Thymectomy and subtotal strumectomy were performed.

In 26 patients, the mediastinal pleura was damaged during the operation, including 8 patients on both sides. There were no complications associated with surgical pneumothorax. If the pleura is not damaged during the operation, the anterior mediastinum is drained with one rubber tube, the end of which is brought into the lower corner of the wound or through a separate puncture below the xiphoid process and connected to suction. Following thymectomy, a tracheostomy (preventively) was performed in 5 patients.

If the operation of thymectomy itself, in comparison with other thoracic operations, is not particularly difficult, then the course of the postoperative period in a number of patients is accompanied by complications, in the 1st place among which is myasthenic crisis. Therefore, operations for myasthenia gravis are possible only in those institutions where it is possible to provide round-the-clock supervision of an anesthesiologist-resuscitator, as well as multi-day mechanical ventilation of the lungs.

The issue of prescribing anticholinesterase drugs in the postoperative period has not been finally resolved. In order to reduce bronchial hypersecretion, it is better to prescribe prozerin with small doses of atropine.

A severe myasthenic crisis with respiratory, cardiac activity, swallowing disorders, etc. was observed in the first days after surgery in 26 patients. 7 patients managed to get out of the crisis by conservative measures; 19 patients underwent a tracheostomy with their transfer to machine breathing, the duration of which ranged from 3 to 40 days. Mucus from the tracheobronchial tree is systematically aspirated around the clock through the tracheostomy. Nutrition of patients who are on hardware breathing is carried out through a probe. In addition to drug treatment, the use of oxygen, the use of breathing exercises, in recent years, all patients with myasthenia gravis in the postoperative period undergo a therapeutic massage of the whole body, repeated several times a day.

The tracheostomy tube is removed after the patient is able to breathe spontaneously.

Of the 43 operated on for myasthenia, 3 patients died in the first days after the operation. This refers to the period when these operations were only being mastered in the clinic. All patients were operated on in serious condition. Long-term results were observed in 26 patients: recovery occurred in 17 patients and improvement (patients take anticholinesterase drugs) in 8 patients; the condition remained unchanged in 3 patients. Two operated patients died of a recurrence of malignant thymoma (one with myasthenia phenomena after 3 years, the other with myocardial infarction).

Benign tumors of the thymus gland (thymomas) are rounded nodes with a dense capsule. Histological examination of these tumors along with connective tissue cells reveals fibroblasts and concentrically located elongated epithelial cells resembling Hassal's bodies. These tumors resemble sclerosing angioma in structure, they are also called reticular perithelioma (Pope and Osgood). A special place is occupied by lipothymomas. Some authors classify them as benign tumors, others as malignant (Andrus and Foot). These tumors often reach large sizes and consist of fatty lobular tissue containing accumulations of thymocytes and gassal bodies. If the tumor is dominated by adipose tissue, it is recommended to call it lipothymoma, if elements of the thymus gland predominate - thymolipoma.

Among our patients, we observed 3 (2 men and 1 woman, all older than 40 years) with lipothymoma. Their tumor was small in size, with even clear boundaries; The tumor was regarded by us as benign. The disease was accompanied by moderate symptoms of myasthenia gravis. One of these patients was admitted with complaints of weakness and fatigue; further examination revealed severe hypoplastic anemia. The patient is operated on; favorable results were noted in the immediate postoperative period.

Of our 15 patients with benign thymomas, 9 (4 men and 5 women) had myasthenia gravis, in the rest the tumor did not manifest itself and was detected by chance.

Malignant thymomas are dense, tuberous tumors of various sizes, often growing into the capsule. In patients with these neoplasms, due to the rapid growth of the tumor, the germination of neighboring organs or their compression, mediastinal compression syndrome develops early. Patients complain of pain behind the sternum, a feeling of pressure in the chest, etc. Often, malignant thymomas occur with myasthenia gravis, which we noted in 5 out of 8 patients. Malignant thymoma can be completely asymptomatic. We give an example.

Patient M., aged 19, was admitted on March 17, 1966. There are no complaints. After graduating from high school, during a medical examination for admission to an educational institution, a tumor formation in the anterior mediastinum was detected radiographically. There are no signs of myasthenia gravis. Pneumomediastinography: in the anterior mediastinum, an oblong-shaped formation 15 * 5 cm in size, shrouded in gas from all sides, with areas of enlightenment in the center; conclusion: tumor of the thymus, possibly with areas of decay. A thymectomy was performed. Histologically: malignant thymoma of the retinulocellular type. Postoperative radiotherapy was performed. Examined 4 years after surgery: no complaints, good condition, no signs of recurrence.

The differential diagnosis of benign and malignant thymomas is often difficult. Malignant thymoma on radiological signs resembles lymphogranulomatosis and lymphosarcoma. In contrast to these formations, thymoma is located directly behind the sternum, usually oval-flattened or cone-shaped. Any thymoma, whether it occurs with or without myasthenia gravis, must be removed. There are indications in the literature that each thymoma should be considered as a potentially malignant tumor (BV Petrovsky; Seybold et al., etc.).

Cysts of the thymus are quite rare. Usually these are thin-walled formations of various sizes, located in the thickness of the gland, filled with a yellowish or brownish liquid. Due to the elasticity of these formations, there are no signs of compression of the surrounding organs. The clinical picture of cysts, if they occur without myasthenia gravis, is poor. As a rule, they are discovered by chance, during a routine examination. All of our 4 patients (3 women and 1 man) were older than 40 years (41 years - 48 years). None of the patients had signs of myasthenia gravis, although combinations of thymus cysts and myasthenia gravis have been described. All were operated (thymectomy) with a favorable result.

In 3 patients operated on by us, the tumor of the anterior mediastinum was a teratoma according to its histological structure. Given the close connection of the formation with the remnants of the thymus gland and the presence of thymus tissue in the formation itself, we regarded the tumor as a teratoma of the thymus gland. In 2 patients, on the basis of signs (the appearance of sebaceous masses in the sputum, hair in one patient, as well as the detection of organoid inclusions on a radiograph in another), the diagnosis was made before surgery, in the third patient - only during surgery. Of the 3 operated patients in 2, it was necessary to remove not only the teratoid formation, but also the lobe of the lung due to the involvement of the latter in the process (a breakthrough of a festering teratoma into the upper lobe bronchus). A high degree of malignant transformation of teratoid formations, the possibility of suppuration and other complications convince of the need for early and radical surgical removal of these neoplasms.

The question of the possibility of an isolated lesion of the thymus by lymphogranulomatosis seems to be controversial. We observed 2 patients who were diagnosed with "tumor of the thymus" before the operation. After the operation, during the histological examination of the preparations, the diagnosis was changed: an isolated lesion of lymphogranulomatosis of the thymus. Taking into account the indications of the possibility of an isolated lesion of the thymus in the early stages of the disease (S. A. Gadzhiev and V. V. Vasiliev), we attributed both of these observations to the pathology of the thymus. After the operation, patients are followed up for 5 years. There are no signs of recurrence and generalization of the process.

The disease, which consists in a combination of thymus pathology and hypoplastic anemia, which occurs as a result of selective damage to the bone marrow without changes in the production of leukocytes and platelets, was first described by Katznelson in 1922. Later it was suggested that the thymus affects the hematopoietic function of the bone marrow, the regulation of the composition of protein fractions, the state of the lymphoid system, etc. (Soutter et al.). Since then, some authors have published data on individual operations on the thymus for various blood diseases (AN Bakulev, 1958; Chaemers and Boheimer, and others). To date, we have performed 4 thymectomy operations in patients with hypoplastic anemia. It is too early to talk about the results of these operations, since after them a short period has passed. Immediate results are satisfactory in 3 patients.

conclusions

In the thymus, a number of pathological processes occur that require surgical treatment.
Surgical treatment for myasthenia gravis is justified both in the presence of a radiographically and clinically detectable tumor, and only in thymus hyperplasia.
Surgery is recommended as soon as the diagnosis is made. Radiation treatment is advisable to carry out after removal of a malignant tumor or if it is impossible to perform a radical operation.

LITERATURE.

1) Bakulev A.N., Kolesnikova R.S. Surgical treatment of tumors and cysts of the mediastinum. M., 1967.

2) Braitsev V. R. Congenital dysontogenetic formations of the mediastinum and lungs. M., 1960.

3) Gadzhiev S. A., Dogel L. V., Vanevsky V. L. Diagnosis and surgical treatment of myasthenia gravis. L., 1971.

4) Gadzhiev S. A., Vasiliev V. Med newspaper, 1973, No. 15.

5) Kuzin M. I. Klin honey, 1969, No. 11, p. 6.

6) Kuzin M.I., Uspensky L.V., Volkov B.P. Vesti, hir., 1972, No. 7, p.48.

7) Osipov B.K. Surgical diseases of the lungs and mediastinum. M., 1961.

8) Petrovsky B. V. Surgery of the mediastinum. M., 1960.

9) Andgus W., Foot N., J. thorac. Surg., 1937, v. 6. p. 648.

10) Chaemers G., Boheimer K., Brit. med. J., 1954, v.2, p.1514.

11) Pope R., O s g o o d R., Am. J. Path., 1953, v. 20, p. 85.

12) S e y b o 1 d W., D o n a 1 d M. C., J. thorac. Surg. Clagett C. et al., 1950, v. 20, p.195.

13) Soutter G., Sommers Sh. R e 1 m o n Ch. et al. Ann. Surg., 1957, v. 146, p. 426.

14) Viets H. Brit. med. J., 1950, v. 1, p.139.

Text restoration, computer graphics - Sergey Vasilyevich Stonogin.

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In the human body, there are a large number of glands that produce substances that are necessary for its normal functioning. One of them is the thymus gland. In adults, it reaches a weight of thirty grams. The thymus gland has other names, for example, thymus. In general, it is considered the central organ of formation in adults located behind the sternum. It consists of the right and left lobes, which are interconnected by loose fiber. It should be noted that the thymus begins to form earlier and faster than other organs of our immune system. In addition, her weight in a newborn baby reaches thirteen grams. However, in the future, ninety percent of the thymus is replaced by fat-type fiber. Most often, the period of active growth of the human body coincides with the activity of the thymus gland.

The thymus is involved in two types of immune response in the human body. We are talking about reactions of the humoral and cellular type. In the first case, the thymus gland in adults takes part in the production of antibodies, in the second - in the process of rejection of various kinds of transplants. As for the production of specific antibodies, B-lymphocytes are responsible for this, and T-lymphocytes are responsible for the rejection of foreign tissue. In both cases, these bodies are formed as a result of changes and transformations of bone marrow cells. The hormones produced by the thymus gland in adults and children convert the stem cell into thymocytes. They, in turn, enter the lymph nodes or the spleen. As a result, thymocytes are transformed and become T-lymphocytes. In the opinion of most experts, stem cells turn into B-lymphocytes directly in the bone marrow itself.

In addition to the fact that the thymus is involved in the transformation of bone marrow cells, thymus is constantly produced in this gland thymopoietin and thymosin, which are hormones that play a major role in the immune responses of our body.

There are many violations of the functions of this body. There are also children who do not have a thymus gland at all. Symptoms indicating a lack of functioning are nothing more than a decrease in the resistance of the human body to any infectious diseases. Other features may also be included. For example, breathing disorders, muscle fatigue, heaviness of the eyelids, the appearance of tumors. In addition, in such a situation, violations occur directly in the immune system at the cellular level. In addition to all this, they can develop which are ailments in which the body destroys its own cells, since the immune system is unable to recognize them and distinguish them from a virus and foreign cells, for example.

Thymus dysfunctions can be not only congenital, but also acquired. Sometimes there is a defeat of the thymus gland, its tissues (radioactive rays). However, in most cases, the causes of violations of the functions of this organ cannot be established.

If the thymus gland is enlarged, which is typical for newborn babies, we can talk about the presence of thymomenalia. This is often caused by some childhood ailments, external factors. It is worth noting that this disease is considered genetic. Its development can be affected by infection of the mother during pregnancy, nephropathy. A specialist can easily determine an enlarged thymus gland in an infant by some symptoms. For example, in such a situation, swollen tonsils, adenoids, and swollen lymph nodes are most often observed. An x-ray can be taken, which will immediately show an enlarged thymus.

Functional disorders of the described organ are successfully treated today. Sometimes the thymus needs to be removed. However, in addition to this, the doctor may prescribe special drugs. In any case, a sick person is most often isolated in order to reduce the risk of infection. If you notice that you get sick much more often, and the disease (infectious) lasts longer, contact your doctor. He will prescribe an examination and select the most appropriate course of treatment.

The thymus gland, or thymus, is the central organ of humans and some types of animals, which is responsible for the immune system of the body.

Between the ages of 20 and 25, the thymus ceases to function in humans, and subsequently it is converted into fatty tissue.

The thymus performs many useful functions, and if they are disturbed, a person can develop various diseases. We will study what the thymus gland is in adults, the symptoms of the disease of this organ, changes in its work.

The thymus gland is located in the upper part of the chest, near the anterior mediastinum. An organ is formed on the 42nd day in fetal development.

The thymus gland in childhood is much larger than in the adult generation and may be located closer to the heart.

The organ continues normal growth until the age of 15, and then the reverse development of the thymus gland begins.

As already mentioned, by about the age of 25, and sometimes even earlier, the thymus ceases to perform its functions and all the glandular tissues of the organ in an adult are replaced by connective and fatty ones.

It is for this reason that adults are much more susceptible to various infections and oncological pathologies.

Functions of the thymus gland in adults

The thymus performs the following important functions in the human body:

The thymus produces many hormones: thymosin, thymalin, thymopoietin, IGF-1, or insulin-like growth factor-1, humoral factor. All these hormones are proteins, polypeptides, and in one way or another participate in the formation of the human immune system.
Carries out the production of lymphocytes, the main cells of the immune system that are involved in the production of antibodies.
T cells mature in the gland, which are the central regulator of the immune response.
In the thymus, the destruction of internal aggressive cells that attack healthy ones occurs.
The thymus gland filters the blood and lymph that flows through it.

Due to the normal functioning of the thymus gland, the human body steadfastly responds to all infectious invasions and various diseases.

Thymus gland diseases - symptoms in adults

With various changes in the work of the thymus, the following symptoms are usually observed in the body of an adult:

muscle fatigue is noticeable;
there is "heaviness" in the eyelids;
breathing is disturbed;
long recovery after various infectious diseases, even the simplest ones, such as SARS.

Often the manifestation of symptoms is due to the fact that some diseases are already developing in the body. Therefore, when they are detected, it is better to immediately consult a doctor for further examination.

How to determine the increase in the thymus?

An increase in the thymus gland indicates that the normal functioning of this organ is impaired.

In addition, the thymus gland can be enlarged for hereditary reasons.

It can be impossible to determine an increase in the gland by “touch”, but with the help of an x-ray of the lungs in a direct projection, a change in its size is quite easy to trace.

If x-rays are taken regularly, then thymus deformity can be recognized at an early stage.

In addition, an increase in the thymus can be diagnosed using ultrasound.

Ultrasound and X-ray do not give an accurate diagnosis of thymus enlargement, therefore, to confirm it, doctors prescribe a more accurate diagnosis - magnetic resonance imaging. It much more accurately determines the change in the size of the thymus.

Graves' disease is a serious disease, but at the moment the exact cause of the onset of the disease has not been established. Let's take a look at the symptoms of this disease.

Causes of thymus enlargement

The thymus can increase due to various pathologies that occur in the body. A signal of their appearance is evidenced by the exacerbating symptoms that were described above.

So, a consequence of an increase in the size of the thymus gland can be:

infectious diseases of varying severity;
malignant and benign tumors, including oncological pathologies;
thymoma;
myasthenia gravis;
T cell lymphoma;
endocrine neoplasia of the first type;
MEDAC syndrome;
Di George's syndrome;
violation of the immune system, etc.

All causes of thymus enlargement are dangerous and require urgent treatment.

Treatment of thymus pathologies

Each patient with thymus disease corresponds to a certain treatment, which depends on the type of disease, the individual characteristics of the human body and some other factors.

At the same time, an immunologist deals with problems with the immune system, and if the thymus disease occurs due to various tumors, then an oncologist treats.

Patients with thymus pathology are prescribed different types of therapy - drug, substitution, symptomatic, immunomodulatory, sometimes traditional medicine is also prescribed.

Immunomodulators, corticosteroids, drugs that normalize calcium metabolism in the body, etc. are used.

Sometimes, it is possible to get rid of the disease by removing the enlarged thymus or with the help of surgery.

diet therapy

Nutrition for pathologies of the thymus gland is important and is controlled by doctors, both during the period of treatment and as a method of prevention.

At the same time, the diet can be prescribed not only for children, but also for adults. The diet of a person with thymus disease should include:

ascorbic acid, or vitamin C, which is found, for example, in foods such as broccoli, rose hips, lemon, sea buckthorn;
vitamin D - beef, liver, egg yolk, some dairy products, brewer's yeast, walnuts;
zinc element - pumpkin seeds, sunflower seeds, etc.

The diet helps to strengthen the immune system and maintain the work of the gland, so it should be strictly observed.

ethnoscience

Traditional medicine is used only as a therapy that enhances immunity. Plants that help strengthen the immune system include:

rose hip;
black currant;
nettle;
rowan and many others.

There are a lot of recipes based on these plants. Let's take a look at some of them.

Decoction of wild rose and blackcurrant

Ingredients:

rosehip (1/2 tbsp);
blackcurrant (1/2 tbsp);
boiled water (2 tbsp.).

Blackcurrant and wild rose are poured with water and put on fire. After it boils, boil the resulting mixture for 10 minutes. Then leave to infuse for 2 hours in a container with a tightly closed lid. The decoction is taken in half a glass 3 times a day.

A decoction of rowan and nettle

Ingredients:

nettle (3 parts);
rowan (7 parts);
water (2 tbsp.).

Method of preparation and use:

All parts of nettle and rowan are mixed. From the mixture take 1 tablespoon and pour boiling water. They put it on fire.

After boiling, cook for another 10 minutes, and then insist 4 hours in a closed container. Take half a glass in the morning, afternoon and evening.

Alternative therapy is very effective in strengthening immunity.

The news that the thymus gland is able to prolong youth has been around for a long time and there are many who want to “renew” this organ after it has ceased to function.

But no one performs thymus transplantation operations, since they are very dangerous and require transplantation not only of the thymus gland, but also of many other organs up to the bone marrow.

An alternative was another way to "renew" the organ - the introduction of embryonic stem cells into the thymus.

This method promises to completely restore the fading thymus and restore youth and health to a person. Supporters of this technique claim that such an injection really works.

The thymus gland is a vital organ and requires special attention even after it ceases to function. In adults, the thymus shows its symptoms most pronounced, which means that dangerous diseases can appear, so it is important to be examined in a timely manner and strengthen the immune system.

Symptoms

Symptoms depend on their cause: dysfunction of the immune system, autoimmune disease, tumor.
Decreased resistance to infectious diseases.
Muscle fatigue.
"Heavy" eyelids.
Respiratory failure.

Causes

Dysfunctions of the thymus gland can be congenital, they can also appear as a result of damage to the thymus tissue by radioactive rays. Unfortunately, the causes often remain unknown.

The main symptom is frequent various infectious diseases. The loss of the function of the T-lymphocyte system is diagnosed by laboratory tests, for example, when the AIDS virus in the body decreases sharply T-lymphocytes of a certain subgroup. In autoimmune diseases, the thymus often enlarges and resembles a tumor. Enlargement of the thymus can be diagnosed by taking an x-ray or examining it with ultrasound. Often the thymus is removed, the condition of patients usually improves, and occasionally they fully recover. There are also malignant tumors.

Treatment

Different diseases of the thymus gland are treated differently. Sometimes it is possible to cure simply by removing the enlarged thymus. In addition, there are various drugs, however, they are not always effective. In severe cases, the patient has to be isolated, thereby minimizing the risk of possible infection.

It is necessary to consult a doctor in case of frequently recurring infectious diseases.

The doctor thoroughly examines the patient, performs the necessary laboratory and X-ray studies.

Treatment will be prescribed in accordance with the symptoms of the disease.

When the function of the immune system is impaired, a person becomes less resistant to all types of infectious pathologies.

In addition, the course of an autoimmune disease is often unfavorable.

If you often get sick with various infectious diseases, you may have impaired the protective ability of the body's immune system, so consult a doctor immediately.