{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:20:42Z","timestamp":1764739242055,"version":"3.46.0"},"reference-count":51,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100238"],"award-info":[{"award-number":["82100238"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021171","name":"Guangdong Basic and Applied Basic Research Foundation","doi-asserted-by":"crossref","award":["2024A1515011063"],"award-info":[{"award-number":["2024A1515011063"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Science and Technology Program of Guangzhou","award":["202201011046"],"award-info":[{"award-number":["202201011046"]}]},{"name":"Medical Scientific Research Foundation of Guangdong Province","award":["A2019063"],"award-info":[{"award-number":["A2019063"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Amyloid A (AA) amyloidosis is commonly secondary to chronic inflammatory diseases or malignant neoplasms. Many types of cancers have been described as inducing AA amyloidosis, usually presenting with kidney involvement. However, there are no reported cases of concurrent thymoma and AA amyloidosis. Case Presentation: We describe a 52-year-old male presenting chest tightness. Through a series of examinations, the patient was ultimately confirmed to have AA amyloidosis secondary to thymoma, with kidney, cardiac, nerve, and soft tissue involvement. Conclusions: This case represents, to our knowledge, the first reported case of systemic AA amyloidosis occurring secondary to thymoma. It highlights thymoma as a potential underlying cause of AA amyloidosis, likely due to a chronic inflammatory response driven by the tumor. This association complicates clinical management and prognosis, requiring a heightened awareness of amyloidosis in thymoma patients who present with unexplained multi-organ dysfunction.<\/jats:p>","DOI":"10.3390\/diagnostics15233040","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:31:46Z","timestamp":1764689506000},"page":"3040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Amyloid A Amyloidosis Secondary to Thymoma"],"prefix":"10.3390","volume":"15","author":[{"given":"Mengyuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Hematology, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China"},{"name":"School of Medicine, South China University of Technology, Guangzhou 510006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Pathology, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingji","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Hematology, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China"},{"name":"Guangdong Cardiovascular Institute, Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0862-4224","authenticated-orcid":false,"given":"Jinghua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China"},{"name":"School of Medicine, South China University of Technology, Guangzhou 510006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/978-94-007-5416-4_20","article-title":"Systemic AA Amyloidosis","volume":"Volume 65","author":"Pinney","year":"2012","journal-title":"Subcell Biochem"},{"key":"ref_2","first-page":"1074","article-title":"Incidence of amyloidosis over 3 years: The AMYPRO study","volume":"26","author":"Dupond","year":"2008","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_3","first-page":"831903","article-title":"Nephrotic Syndrome Associated with Lung Cancer: A Rare Case of Malignancy Associated with AA Amyloidosis","volume":"2013","author":"Gueutin","year":"2013","journal-title":"Case Rep. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"564","DOI":"10.2340\/0001555563564567","article-title":"Giant basal cell carcinoma with metastasis and secondary amyloidosis: Report of case","volume":"63","author":"Beck","year":"1983","journal-title":"Acta Derm. Venereol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"594","DOI":"10.4103\/ijpm.ijpm_461_21","article-title":"Secondary amyloidosis with concomitant gastric GIST and gastric adenocarcinoma\u2014A case report","volume":"66","author":"Soni","year":"2023","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s13730-013-0088-8","article-title":"Renal cell carcinoma presenting as AA amyloidosis: A case report and review of the literature","volume":"3","author":"Babu","year":"2014","journal-title":"CEN Case Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1056\/NEJMoa070265","article-title":"Natural history and outcome in systemic AA amyloidosis","volume":"356","author":"Lachmann","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1016\/S0140-6736(15)01274-X","article-title":"Systemic amyloidosis","volume":"387","author":"Wechalekar","year":"2016","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/00005792-199107000-00002","article-title":"Secondary systemic amyloidosis: Response and survival in 64 patients","volume":"70","author":"Gertz","year":"1991","journal-title":"Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.rdc.2018.06.004","article-title":"Secondary, AA, Amyloidosis","volume":"44","author":"Papa","year":"2018","journal-title":"Rheum. Dis. Clin. North Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.revmed.2017.03.003","article-title":"Thymoma and autoimmune diseases","volume":"39","author":"Jamilloux","year":"2018","journal-title":"Rev. Med. Interne"},{"key":"ref_12","first-page":"411","article-title":"Systemic amyloidosis and non-hematologic malignancy in a large autopsy series","volume":"89","author":"Dictor","year":"1981","journal-title":"Acta Pathol. Microbiol. Scand. Sect. A Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1136\/jcp.19.6.539","article-title":"Systemic amyloidosis and malignant disease","volume":"19","author":"Azzopardi","year":"1966","journal-title":"J. Clin. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1093\/ndt\/gfac217","article-title":"AA amyloidosis associated with cancers","volume":"38","author":"Bharati","year":"2023","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1210\/jcem-19-1-152","article-title":"Medullary (solid) carcinoma of the thyroid; a clinicopathologic entity","volume":"19","author":"Hazard","year":"1959","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s13730-020-00530-5","article-title":"Cervical cancer of the uterus complicated by renal AA amyloidosis","volume":"10","author":"Fujisawa","year":"2021","journal-title":"CEN Case Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S0168-8278(86)80056-3","article-title":"Systemic reactive amyloidosis caused by hepatocellular adenoma. A Case report","volume":"2","author":"Thysell","year":"1986","journal-title":"J. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1136\/thx.45.2.156","article-title":"Systemic amyloid associated with carcinoma of the bronchus","volume":"45","author":"Richmond","year":"1990","journal-title":"Thorax"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1136\/pgmj.70.825.505","article-title":"Systemic amyloidosis and ovarian carcinoma","volume":"70","author":"Mateo","year":"1994","journal-title":"Postgrad. Med. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1067\/msy.2001.113441","article-title":"Retroperitoneal follicular dendritic cell sarcoma presenting as secondary amyloidosis","volume":"130","author":"Chiaramonte","year":"2001","journal-title":"Surgery"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1053\/ajkd.2002.34545","article-title":"Systemic amyloidosis associated with pleomorphic sarcoma of the spleen and remission of nephrotic syndrome after removal of the tumor","volume":"40","author":"Agha","year":"2002","journal-title":"Am. J. Kidney Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1093\/ndt\/gfg391","article-title":"Systemic AA amyloidosis and nephrotic syndrome associated with small cell carcinoma of the bladder","volume":"18","author":"Kanat","year":"2003","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1093\/ndt\/gfg063","article-title":"Carcinoma of the bronchus presenting as renal failure secondary to amyloidosis","volume":"18","author":"Garthwaite","year":"2003","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3109\/13506129.2012.712926","article-title":"Systemic AA amyloidosis in a patient with lung metastasis from renal cell carcinoma","volume":"19","author":"Nobata","year":"2012","journal-title":"Amyloid"},{"key":"ref_25","first-page":"250604","article-title":"The Hidden Cost of Untreated Paragangliomas of the Head and Neck: Systemic Reactive (AA) Amyloidosis","volume":"2015","author":"Dervisoglu","year":"2015","journal-title":"Case Rep. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e25961","DOI":"10.1097\/MD.0000000000025961","article-title":"Lung cancer combined with diffuse peritoneal and mesenteric amyloidosis detected on 18F-FDG PET\/CT: A case report","volume":"100","author":"Wang","year":"2021","journal-title":"Medicine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1111\/1346-8138.17203","article-title":"A case of AA amyloidosis complicated by proliferating pilomatricoma and a review of the literature","volume":"51","author":"Obara","year":"2024","journal-title":"J. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s00595-004-2750-4","article-title":"Amyloid tumor in the anterior mediastinum: Report of a case","volume":"34","author":"Takamori","year":"2004","journal-title":"Surg. Today"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/s13256-017-1370-8","article-title":"Sclerosing thymoma-like thymic amyloidoma with nephrotic syndrome: A case report","volume":"11","author":"Kato","year":"2017","journal-title":"J. Med. Case Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"cr-25","DOI":"10.70352\/scrj.cr.25-0196","article-title":"Thymic Amyloidosis Mimicking Thymoma: A Case Report","volume":"11","author":"Tomida","year":"2025","journal-title":"Surg. Case Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"105628","DOI":"10.1016\/j.humpath.2024.105628","article-title":"Salivary gland amyloidosis: Proteomic identification and clinicopathologic characterization of 57 cases","volume":"151","author":"Chiu","year":"2024","journal-title":"Hum. Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1136\/jclinpath-2014-202722","article-title":"A comparison of immunohistochemistry and mass spectrometry for determining the amyloid fibril protein from formalin-fixed biopsy tissue","volume":"68","author":"Gilbertson","year":"2015","journal-title":"J. Clin. Pathol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/cjp2.126","article-title":"The complementary role of histology and proteomics for diagnosis and typing of systemic amyloidosis","volume":"5","author":"Rezk","year":"2019","journal-title":"J. Pathol. Clin. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1182\/blood-2014-11-609883","article-title":"A practical approach to the diagnosis of systemic amyloidoses","volume":"125","author":"Verga","year":"2015","journal-title":"Blood"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1182\/blood-2011-07-365510","article-title":"Reliable typing of systemic amyloidoses through proteomic analysis of subcutaneous adipose tissue","volume":"119","author":"Brambilla","year":"2012","journal-title":"Blood"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1007\/s10875-007-9147-2","article-title":"Thymopoiesis, regulatory T cells, and TCRVbeta expression in thymoma with and without myasthenia gravis, and modulatory effects of steroid therapy","volume":"28","author":"Fattorossi","year":"2008","journal-title":"J. Clin. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Ao, Y.Q., Jiang, J.H., Gao, J., Wang, H.K., and Ding, J.Y. (2022). Recent thymic emigrants as the bridge between thymoma and autoimmune diseases. Biochim. Biophys. Acta Rev. Cancer, 1877.","DOI":"10.1016\/j.bbcan.2022.188730"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3872","DOI":"10.1182\/blood.V96.12.3872","article-title":"Thymomas alter the T-cell subset composition in the blood: A potential mechanism for thymoma-associated autoimmune disease","volume":"96","author":"Hoffacker","year":"2000","journal-title":"Blood"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1001\/archinte.1974.00320200184029","article-title":"The spectrum of diseases associated with thymoma. Coincidence or syndrome?","volume":"134","author":"Souadjian","year":"1974","journal-title":"Arch. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.autrev.2015.09.005","article-title":"Thymoma associated with autoimmune diseases: 85 cases and literature review","volume":"15","author":"Bernard","year":"2016","journal-title":"Autoimmun. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1007\/s10067-020-05061-z","article-title":"A tale of autoimmunity: Thymoma, thymectomy, and systemic lupus erythematosus","volume":"39","author":"Mollaeian","year":"2020","journal-title":"Clin. Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1146\/annurev-pathol-020712-163913","article-title":"AA amyloidosis: Pathogenesis and targeted therapy","volume":"10","author":"Westermark","year":"2015","journal-title":"Annu. Rev. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1056\/NEJMc1805673","article-title":"Systemic AA Amyloidosis Caused by Inflammatory Hepatocellular Adenoma","volume":"379","author":"Calderaro","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.lungcan.2008.07.018","article-title":"Interleukin-6-producing undifferentiated thymic carcinoma with neuroendocrine features","volume":"63","author":"Suzuki","year":"2009","journal-title":"Lung Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1369\/jhc.2010.956821","article-title":"Expression of serum amyloid a in human ovarian epithelial tumors: Implication for a role in ovarian tumorigenesis","volume":"58","author":"Dishon","year":"2010","journal-title":"J. Histochem. Cytochem."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"871","DOI":"10.2169\/internalmedicine.41.871","article-title":"Interleukin-6-producing thymic squamous cell carcinoma associated with Castleman\u2019s disease and nephrotic syndrome","volume":"41","author":"Matsumura","year":"2002","journal-title":"Intern. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3109\/13506129.2014.1002031","article-title":"AA amyloidosis treated with tocilizumab: Case series and updated literature review","volume":"22","author":"Courties","year":"2015","journal-title":"Amyloid"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Liu, D., Zhang, P., Zhao, J., Yang, L., and Wang, W. (2021). Identification of Molecular Characteristics and New Prognostic Targets for Thymoma by Multiomics Analysis. Biomed. Res. Int., 2021.","DOI":"10.1155\/2021\/5587441"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.amjmed.2009.11.010","article-title":"Long-term TNF-alpha blockade in patients with amyloid A amyloidosis complicating rheumatic diseases","volume":"123","author":"Castro","year":"2010","journal-title":"Am. J. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1056\/NEJMoa065644","article-title":"Eprodisate for the treatment of renal disease in AA amyloidosis","volume":"356","author":"Dember","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1056\/NEJMoa1504942","article-title":"Therapeutic Clearance of Amyloid by Antibodies to Serum Amyloid P Component","volume":"373","author":"Richards","year":"2015","journal-title":"N. Engl. J. Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/23\/3040\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:16:41Z","timestamp":1764739001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/23\/3040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":51,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["diagnostics15233040"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15233040","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,11,28]]}}}