Poster électronique

Rebond thymique et IRM
NH. Kraiem, M. Ouldyehdih, K. Nouira, M. Jamoussi - Tunis - Tunisie
Congrès 2011
Résumé
Objectifs
L’objectif est de décrire le phénomène de rebond thymique et de montrer l'intérêt des séquences IRM en phase et en opposition de phase permettant de surseoir à la biopsie.
Matériels et méthodes
Nous rapportons 3 observations d'hyperplasie thymique survenant en phase de rémission d’un lymphome traité par chimiothérapie. Les 3 patients ont bénéficié d'un scanner cervicothoracoabdominopelvien rentrant dans le cadre de la surveillance postthérapeutique puis d'une IRM médiastinale comportant des séquences SET1, SET2 et des séquences Echo de gradient T1 en phase et en opposition de phase.
Résultats
Le scanner a montré dans les trois cas, dans un délai moyen de 8 mois après la fin du traitement (4 mois à 12 mois), l'apparition d'une masse tissulaire rétrosternale alors que la réponse était complète sur le scanner de fin de traitement. En IRM, la masse était de signal intermédiaire en T1 et en T2 et présentait une chute du signal sur les séquences Echo de Gradient T1 en opposition de phase comparées aux séquences en phase. Les contrôles scanographiques ultérieurs ont montré la stabilité de la masse (sur 9 mois).
Conclusion
Le rebond thymique est un phénomène classique à connaître en oncologie car il peut simuler une reprise évolutive. L'IRM permet de conforter le diagnostic et d'éviter le recours à la biopsie.
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2017-08-30 00.59 :
Ann Perez

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