Porubsky, StefanPopovic, Zoran V.Badve, SunilBanz, YaraBerezowska, SabinaBorchert, DietmarBrüggemann, MonikaGaiser, TimoGraeter, ThomasHollaus, PeterHuettl, Katrin S.Kotrova, MichaelaKreft, AndreasKugler, ChristianLötscher, FabianMöller, BurkhardOtt, GermanPreissler, GerhardRoessner, EricRosenwald, AndreasStröbel, PhilippMarx, Alexander2024-03-122024-03-122021-01-16Porubsky S, Popovic ZV, Badve S, et al. Thymic Hyperplasia with Lymphoepithelial Sialadenitis (LESA)-Like Features: Strong Association with Lymphomas and Non-Myasthenic Autoimmune Diseases. Cancers (Basel). 2021;13(2):315. Published 2021 Jan 16. doi:10.3390/cancers13020315https://hdl.handle.net/1805/39213Thymic hyperplasia (TH) with lymphoepithelial sialadenitis (LESA)-like features (LESA-like TH) has been described as a tumor-like, benign proliferation of thymic epithelial cells and lymphoid follicles. We aimed to determine the frequency of lymphoma and autoimmunity in LESA-like TH and performed retrospective analysis of cases with LESA-like TH and/or thymic MALT-lymphoma. Among 36 patients (21 males) with LESA-like TH (age 52 years, 32-80; lesion diameter 7.0 cm, 1-14.5; median, range), five (14%) showed associated lymphomas, including four (11%) thymic MALT lymphomas and one (3%) diffuse large B-cell lymphoma. One additional case showed a clonal B-cell-receptor rearrangement without evidence of lymphoma. Twelve (33%) patients (7 women) suffered from partially overlapping autoimmune diseases: systemic lupus erythematosus (n = 4, 11%), rheumatoid arthritis (n = 3, 8%), myasthenia gravis (n = 2, 6%), asthma (n = 2, 6%), scleroderma, Sjögren syndrome, pure red cell aplasia, Grave's disease and anti-IgLON5 syndrome (each n = 1, 3%). Among 11 primary thymic MALT lymphomas, remnants of LESA-like TH were found in two cases (18%). In summary, LESA-like TH shows a striking association with autoimmunity and predisposes to lymphomas. Thus, a hematologic and rheumatologic workup should become standard in patients diagnosed with LESA-like TH. Radiologists and clinicians should be aware of LESA-like TH as a differential diagnosis for mediastinal mass lesions in patients with autoimmune diseases.en-USAttribution 4.0 InternationalLESAAutoimmune diseaseImagingLymphomaMyastheniaPathologySurgeryThymic epithelial tumorThymitisThymusArticle