Neurofilament epitopes in thymoma and antiaxonal autoantibodies in myasthenia gravis.

Expression by neoplastic thymic epithelial cells of acetylcholine-receptor (AChR) epitopes is associated with the presence of AChR autoantibodies and the development of myasthenia gravis. We studied thymic tumours from patients with and without myasthenia gravis for the expression of neurofilament epitopes by immunohistochemistry with four monoclonal antibodies. There was very little antibody binding in control samples (healthy thymus, or thymitis) or in medullary and mixed thymomas, but neurofilament epitopes were strongly expressed in all cortical thymomas and thymic carcinomas. In addition, the frequency of serum autoantibodies against axons was significantly higher among myasthenic patients with thymic epithelial tumours than among age-matched controls (7/10 vs 3/50; p less than 0.01).