[A case of hypogamma-globulinemia with thymoma (Good's syndrome) follow-up for 8 years].

A 58-year-old woman, who had a past history of left upper lobectomy with thoracoplasty for pulmonary tuberculosis and resection of thyroid cancer, was diagnosed as having a mediastinal tumor by chest X-ray examination. It was found to be a malignant thymoma (spindle cell type) after resection. The level of serum gammaglobulin, which had been low before resection, progressively decreased. Afterward, she frequently suffered from airway infections which resulted in severe bronchiecatsis. She died due to respiratory failure 8 years later. In the early stage, though the percentage of pan T cells in peripheral blood lymphocyte subsets was normal, CD4 T cells decreased and CD8 T cells increased. A decrease in helper T cells and an increase in cytotoxic T cells were especially marked. In the late stage, all T cells subsets decreased. In particular, naive T (CD45RA* CD3+ T) cells decreased markedly. However, the percentage of B cells remained normal and that of NK cells was elevated. From the findings of lymphocyte subsets and lymphocyte reactivity to PHA stimulation, it is suggested that T cell dysfunction caused hypogrammaglobulinemia in this case.