{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:29:59Z","timestamp":1784042999026,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Germinal centers (GCs) can be observed in the thymic tissues of patients with thymoma\u2010associated myasthenia gravis (MG). Although an association between thymic GCs and MG has been suggested, it is unknown whether the presence of GCs could predict the development of MG after the resection of thymoma, known as postthymectomy MG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of previously nonmyasthenic patients who underwent surgical removal of the thymoma. All available thymic tissue slides were rereviewed by a pathologist to assess for GCs. Patients were classified into GC\u2010positive and GC\u2010negative groups based on the presence of GCs. The incidence of postthymectomy MG was compared between the two groups, and the risk factors for postthymectomy MG were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 196 previously nonmyasthenic patients who underwent thymoma resection, 21 were GC\u2010positive, whereas 175 were GC\u2010negative. Postthymectomy MG developed in 11 (5.6%) patients and showed a higher incidence in the GC\u2010positive group than in the GC\u2010negative group (33.3% vs. 2.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). No postoperative radiotherapy and the presence of GCs were risk factors for postthymectomy MG in the univariate analysis. In multivariate analysis, invasive thymoma (hazard ratio [HR] =\u20099.835, 95% confidence interval [CI] =\u20091.358\u2013105.372), postoperative radiotherapy (HR\u2009=\u20090.160, 95% CI\u2009=\u20090.029\u20130.893), and presence of GCs (HR\u2009=\u200915.834, 95% CI\u2009=\u20093.742\u201367.000) were significantly associated with postthymectomy MG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thymic GCs may be a significant risk factor for postthymectomy MG. Even in patients with thymoma who do not show clinical symptoms of MG, postthymectomy MG should be considered, especially if thymic GCs are observed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16119","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T13:34:17Z","timestamp":1698845657000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Germinal centers are associated with postthymectomy myasthenia gravis in patients with thymoma"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5967-4830","authenticated-orcid":false,"given":"Hye Yoon","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Neurology Yonsei University College of Medicine  Seoul Korea"},{"name":"Department of Neurology Yongin Severance Hospital, Yonsei University Health System  Yongin Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Young","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Chul","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4165-8901","authenticated-orcid":false,"given":"Hyung Jun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology Yonsei University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Gu","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang 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