Pure white cell aplasia combined with thymoma and lung cancer: a case report and literature review

VernacularTitle:纯白细胞再生障碍合并胸腺瘤、肺癌1例报告并文献复习
Author: Xiuli CHEN ¹ ; Zhenjie CAI ; Rong ZHENG ; Wuqiang LIN
Author Information

1. 福建省莆田市第一医院血液内科，莆田　351100
From: Chinese Journal of Hematology 2024;45(8):789-793
CountryChina
Language:Chinese
Abstract: Pure white cell aplasia (PWCA) is a rare hematologic disorder. In this case study, a 67-year-old man presented with severe neutropenia along with thymoma and lung cancer. A comprehensive diagnostic approach was done which included routine blood test, bone marrow cytology, bone marrow pathology, flow cytometry, and thymic pathology. Other potential causes, such as pure red blood cell aplasia and myelodysplastic syndrome, were ruled out. The final diagnosis was determined to be thymoma-related PWCA. Continuous treatment with human granulocyte colony-stimulating factor (G-CSF) was ineffective for treating PWCA in this patient. The patient's white blood cell and neutrophil count increased following treatment with cyclosporine and subsequently returned to normal levels by the 8th day after thymectomy. A recurrence of PWCA was identified 40 days after the operation and coincided with COVID-19 infection. The patient eventually succumbed to a severe infection. Therefore, in cases of severe neutropenia with an unclear etiology, prompt evaluation of mediastinal and bone marrow status is imperative.