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Thymic Langerhans Cell Histiocytosis
Joseph Junewick, MD FACR
over 8 years ago
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ARSt Case Repository

Chronic Granulomatous Disease - Thymus

Case Detail

Anatomy: Chest
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: about 1 year ago
Updated: about 1 year ago
Modality/Study Types: CT PET
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2 year old male with known CGD

Case Images


Chronic granulomatous disease – Thymus

Clinical Notes

Liver abscess diagnosed at 1 year of age.

Image-guided thymus sampling produced 12 mL brown fluid; cultures negative.


CT – Abdomen images show hepatic abscess and left upper quadrant bowel/mesentery inflammation. Chest images show enlarged, heterogeneous thymus.

PET – Central thymus hypometabolic regions corresponding to fluid on CT.


Phagocytosis leads to induction of NADPH and activated oxygen compounds. In CGD, phagocytosis is normal although interruption of NADPH prevents killing of ingested bacteria. CGD is secondary to X-linked (~70%) or autosomal recessive (~30%) defects. Patients experience multiple infections and abscesses in skin, bone, lungs, lymph nodes, and gastrointestinal and genitourinary tracts. Typically, bacteria are catalase producing organisms like S. aureus, E. coli, Serratia, Klebsiella, Pseudomonas. Aspergillus leading cause of death; Serratia infection in a child should prompt the diagnosis of CGD. Thymus involvement may be related to antigen presentation to the thymus during T-cell maturation and involvement of the thymus epithelium.


Godoy MCB, Vos PM, Cooperberg PL, et al. Chest Radiographic and CT Manifestations of Chronic Granulomatous Disease in Adults. AJR (2008); 191:1570-1575.

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