Question

A patient with mediastinal mass was diagnosed with red cell aplasia. What is the probable cause?

• A. Bronchogenic carcinoma
• B. NHL
• C. Thymic neoplasia
• D. T cell ALL

Hint:

Think about which anterior mediastinal tumour is classically associated with autoimmune haematological conditions including pure red cell aplasia.

Answer 1

The Correct Option is C

Step 1: Understand Pure Red Cell Aplasia (PRCA).
Pure Red Cell Aplasia (PRCA) is a disorder characterised by the absence of erythroid precursors in the bone marrow, resulting in severe normocytic anaemia with markedly reduced or absent reticulocytes. It is thought to be an autoimmune disorder.

Step 2: Identify the association with mediastinal mass.
The classic association between a mediastinal mass and PRCA is Thymic neoplasia (Thymoma). Approximately 5% of patients with thymoma develop PRCA. Thymoma is located in the anterior mediastinum and is the most common cause of acquired PRCA associated with a mediastinal mass.

Step 3: Rule out other options.

• Bronchogenic carcinoma: A mediastinal mass from lung cancer does not classically cause PRCA.
• NHL: Non-Hodgkin lymphoma can cause mediastinal masses but is not the classic association with PRCA.
• T cell ALL: Can cause a mediastinal mass (thymic T-cell ALL) but PRCA is not a classic association.

Conclusion: Thymic neoplasia (Thymoma) is the classic cause of mediastinal mass associated with acquired PRCA.