Thymomas are rare and typically benign tumours implicated in up to 50% of anterior mediastinal masses. 1 Thymomas result in immune dysregulation from loss of self-tolerance, leading to changes in cellular and humoral immunity. Pure red cell aplasia (PRCA) is a condition whereby there is selective destruction of erythroid progenitor cells by an autoimmune attack, resulting in severe anaemia with reticulocytopenia, and is the reported in up to 5% of thymoma cases. 2 First described in the 1950s, Good’s syndrome is commonly accepted to be an immunodeficiency syndrome of thymoma associated with hypogammaglobulinaemia. 3 Good’s syndrome remains incompletely understood with no established diagnostic criteria. It is astonishingly rare for a patient to have both PRCA and Good’s syndrome, with evidence limited to case reports and variable treatment approaches. 3
Hedrick et al. (Sun,) studied this question.