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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 57-year-old woman was referred to our hospital for multiple nodules in the bilateral lower lung fields of a chest X-ray image&#46; Her medical history included surgery for ruptured type A thymoma 15 years previously&#44; and follow-up had been completed with no recurrence for more than five years post-surgery&#46; Computed tomography demonstrated several nodules of various sizes in multiple lobes &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A and B&#41;&#44; which exhibited little uptake of <span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose on positron emission tomography-computed tomography &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#46; The tumors were suspected to be metastases&#44; despite these examinations having revealed no primary tumor&#46; Bronchoscopy found a tumor with smooth edges in right B10 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>D&#41;&#44; from which a biopsy was performed&#46; Histopathology revealed that the tumor was composed of proliferating spindle cells and infiltrating T cells which were positive for terminal deoxynucleotidyl transferase &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>E and F&#41;&#46; Thus&#44; the tumors were diagnosed as a recurrence of thymoma&#46; The patient underwent surgical resection of several lung metastases twice at another institution&#46; A few metastatic tumors that were difficult to resect continue to be followed up&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Thymoma recurrence after surgery occurs in less than half of the patient population&#44; and most recurrences appear in the form of pleural dissemination&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#44;2</span></a> Surgery for pulmonary metastases of thymoma&#44; which are relatively rare&#44; can be an option&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Complete resection of recurrent thymoma can result in a favorable outcome&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a> In the present case&#44; although rare&#44; the tumors which were suspected to be hematogenous metastases could be observed and diagnosed by bronchoscopy examination as a recurrence of thymoma&#46; Due to the long duration of recurrence&#44; the patient underwent surgical resections twice&#44; albeit incomplete resections&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Clinical Image
Bronchoscopic Diagnosis of Hematogenous Recurrence of Thymoma
Miki Tasato, Akihiko Sokai
Corresponding author
sokai.med@gmail.com

Corresponding author.
, Takashi Nishimura
Department of Respiratory Medicine, Kyoto Katsura Hospital, 17 Yamadahirao-cho, Nishikyo-ku, Kyoto 615-8256, Japan
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        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0025" class="elsevierStylePara elsevierViewall">We would like to thank Dr&#46; Shinsuke Shibuya &#40;Department of Diagnostic Pathology&#44; Kyoto Katsura Hospital&#41; for pathological evaluations and Prof&#46; Masaaki Sato &#40;Department of Thoracic Surgery&#44; University of Tokyo Hospital&#41; for surgical treatment&#46;</p>"
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Article information
ISSN: 03002896
Original language: English
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