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Thymic enlargement in two cases of Graves' disease.

A 20-year-old woman with type 1 diabetes mellitus was diagnosed as having Graves’ disease. Ultrasonography of the neck revealed an enlarged thyroid (estimated weight, 31 g) and a well-defined solid hypoechoic mass with inner multiple echogenic particles inferior to the thyroid gland (Picture 1). Computed tomography detected an enlarged mass just below the thyroid gland (Picture 2). The shape of the mass was similar to that of the thyroid gland. Thus, a diagnosis of thymic enlargement was made (1, 2). After methimazole treatment for about 1 year, the thymic enlargement resolved. We also had another patient with Graves’ disease (12-year-old boy) who showed a similar mass inferior and lateral to the thyroid gland (Picture 3). The present cases indicate that ultrasonography is a useful tool for detecting thymic enlargement in some patients with Graves’ disease.