Thymoma physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]Ahmad Al Maradni, M.D. [3]
Overview
Patients with thymoma usually appear asymptomatic. Physical examination of patients with thymoma is may be remarkable for neck lump, facial swelling and wheezing.
Physical Examination
The physical examination plays a limited role in the diagnosis of thymoma, it is very important to check general signs for associated diseases.
Apperance
- Patient usually appears well and asymptomatic
Head and Neck
Chest
- Dullness to percussion on the anterior chest
Lungs
- Wheezing may be present
Musculoskeletal
- Muscle weakness may be present (suggestive of myasthenia gravis)
- Joint deformity may be present (suggestive of an associated joint disease)
Skin
- Malar rash May present (suggestive of systemic lupus erythrematouses)
Physical examination of myasthenia gravis (associated with 15% of patients with thymoma) Shows muscle fatigability and can be tested for many muscles.
A thorough examination demonstrates easy fatigability during following movements:
- Looking upward and sidewards for 30 seconds: ptosis and diplopia.
- Looking at the feet while lying on the back for 60 seconds
- Keeping the arms stretched forward for 60 seconds
- 10 Deep knee bends
- Walking 30 steps on both the toes and the heels
- 5 Sit-ups, lying down and sitting up completely