{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:29:19Z","timestamp":1789655359076,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There is limited evidence regarding the impact of World Health Organization (WHO) subtype of thymoma on post\u2010thymectomy outcome of thymoma\u2010associated myasthenia gravis (TAMG). The objective was to determine if the pathological subtypes of thymoma were associated with post\u2010thymectomy outcomes of myasthenia gravis (MG), in patients with TAMG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective study of consecutive patients with TAMG who attended the neuromuscular clinic between January 2018 and December 2019 with a minimum follow\u2010up of 1\u2009y after thymectomy. Outcome measures were MG Impairment Index (MGII), single\u2010simple question (SSQ), Myasthenia Gravis Foundation of America post\u2010intervention status (MGFA PIS) and non\u2010responder MG status at last assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010five patients were included; mean age at onset was 48.1\u2009\u00b1\u200912.1\u2009y; 54(56.8%) were females. Thirteen patients developed MG post\u2010thymectomy. The most common thymoma was WHO type B2 in 39 (41.1%). Most patients (40, 42.1%) had Masaoka stage II thymoma. There was no association of thymoma subtypes or Masaoka stage of disease with age, gender, MG phenotype, serology, post\u2010thymectomy onset, interval from onset to thymectomy, MGII, SSQ, MGFA PIS, or non\u2010responder status. Associations were found between positive serology and lower MGII (11.1\u2009\u00b1\u200914.2 vs 23\u2009\u00b1\u200912.9, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.050), thymic follicular hyperplasia (TFH) and higher SSQ (89.3\u2009\u00b1\u200911.7 vs 80.1\u2009\u00b1\u200920.2, <jats:italic>P<\/jats:italic>\u2010.043), and lack of recurrence and higher SSQ (84.1\u2009\u00b1\u200918 vs 72.5\u2009\u00b1\u200920, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.037).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The WHO pathological subtype of thymoma did not correlate with MG outcomes. However, positive acetylcholine antibody serology, presence of TFH, and non\u2010recurrence of thymoma predict a favorable outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27220","type":"journal-article","created":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T09:54:16Z","timestamp":1615024456000},"page":"868-873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Thymoma pathology and myasthenia gravis outcomes"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-417X","authenticated-orcid":false,"given":"Deepak","family":"Menon","sequence":"first","affiliation":[{"name":"Ellen and Martin Prosserman Centre for Neuromuscular Diseases University Health Network, Toronto General Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Katzberg","sequence":"additional","affiliation":[{"name":"Ellen and Martin Prosserman Centre for Neuromuscular Diseases University Health Network, Toronto General Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-0221","authenticated-orcid":false,"given":"Carolina","family":"Barnett","sequence":"additional","affiliation":[{"name":"Ellen and Martin Prosserman Centre for Neuromuscular Diseases University Health Network, Toronto General Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prodipto","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University Health Network, Toronto General Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bezjak","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Health Network, Princess Margaret Cancer Centre, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaf","family":"Keshavjee","sequence":"additional","affiliation":[{"name":"Department of Surgery University Health Network, Toronto General Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Bril","sequence":"additional","affiliation":[{"name":"Ellen and Martin Prosserman Centre for Neuromuscular Diseases University Health Network, Toronto General Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000299"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","unstructured":"MarxA Str\u00f6belP WeisC\u2010A.The pathology of the thymus in myasthenia gravis. Mediastinum [online serial]. 2018;2.http:\/\/med.amegroups.com\/article\/view\/4646. Accessed June 7 2020.","DOI":"10.21037\/med.2018.12.04"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000654"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000297"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2019.102337"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.10.068"},{"key":"e_1_2_10_9_1","unstructured":"NarayanaswamiP SandersDB WolfeG et al.International consensus guidance for management of myasthenia gravis: 2020 update. Neurology [online serial].https:\/\/n.neurology.org\/content\/early\/2020\/11\/03\/WNL.0000000000011124. Accessed December 30 2020."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002971"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25720"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-60157-6"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181f20c05"},{"key":"e_1_2_10_14_1","first-page":"623","article-title":"The clinical characteristics of patients with thymoma\u2010associated myasthenia gravis","volume":"51","author":"Chen Y","year":"2012","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)04083-3"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","unstructured":"RomiF.Thymoma in myasthenia gravis: from diagnosis to treatment. Autoimmune Dis [online serial].2011.https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3155972\/. Accessed June 12 2020.","DOI":"10.4061\/2011\/474512"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-007-0185-8"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000393"},{"key":"e_1_2_10_19_1","first-page":"624","article-title":"The World Health Organization histologic classification system reflects the oncologic behavior of thymoma","volume":"94","author":"Okumura M","year":"2002","journal-title":"Cancer [online serial]"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.3.755"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)01139-1"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.05.015"},{"key":"e_1_2_10_23_1","first-page":"205","article-title":"The immunological effects of thymectomy in myasthenia gravis","volume":"36","author":"Scadding GK","year":"1979","journal-title":"Clin Exp Immunol [online serial]"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302507"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2013.02.005"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2005.03.039"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen3.12319"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.01.023"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2008.06.368"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.04.070"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(02)00226-5"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.10255"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27220","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.27220","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:30:08Z","timestamp":1693355408000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,16]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1002\/mus.27220"],"URL":"https:\/\/doi.org\/10.1002\/mus.27220","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,16]]},"assertion":[{"value":"2020-10-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}