2025年 · 第105卷第19期

The patient, a 59-year-old male, was admitted to the Department of Respiratory and Critical Care Medicine, Xichong County People's Hospital on December 1, 2024 due to "cough and blood in sputum for 6 months, aggravated for 10 days". In June 2024, the patient developed cough without obvious trigger, coughed a small amount of white foamy sputum, occasionally with blood in the sputum, which was not taken seriously. On November 21, the cough worsened, with blood in the sputum, no chest pain and dyspnea. Smoking index 80-year package. Physical examination: There was no swelling of superficial lymph nodes, slightly lower breathing sounds in the left upper lung, and scattered wet rales could be heard. Auxiliary examination: Neutrophil count 6.81×10⁹/L, lactate dehydrogenase 379 U/L, neuron-specific enolase 41.26 ng/ml. Chest enhanced CT (Dec. 1, 2024) revealed an anterior mediastinal mass with a maximum section of 5.4 cm ×5.2 cm, unclear boundaries and lobulation, with mild heterogeneous enhancement on the enhancement scan (Fig. 1A, shown by arrows), with bronchotomy in the upper lobe of the left lung (Fig. 1B, 1C, shown by arrows) and mediastinal lymph node enlargement. Bronchoscopy (Dec. 2, 2024): A new organism with fragile texture, abundant blood supply and almost complete lumen occlusion was seen at the bronchial opening in the anterior segment of the upper lobe of the left lung (Figure 1D, shown by arrows), and biopsy pathology showed a malignant tumor. Mediastinal mass puncture biopsy revealed malignancy, immunohistochemistry (06 Dec 2024): PCK (focus +), CK5/6 (-), P40 (-), Ki-67 (+, approximately 40%), CK7 (focus +), TTF-1 (-), Napsin A (-), CD56 (-), CgA (-), Syn (-), CD20 (-), CD3 (-), CD45 (-), S100 (-), HMB-45 (-), Melan-A (-). Pathology Consultation of Sichuan Cancer Hospital (Dec. 16, 2024): (Left Upper Lobe Microscopic Biopsy) Ckpan (AE1/AE3) (+), P40 (small amount +), TTF-1 (individual +), Napsin A (-), Syn (-), CD56 (partial +), Ki-67 (+, approximately 50%), CD117 (+), CD5 (+), thymic cancer of thymic origin is considered; (Mediastinal puncture) SALL4 (individual +), OCT-3/4 (-), PLAP (-), Brg-1 (SMARCA4) (+, not deleted), CgA (-), NSE (-), NKX2.2 (-), SSTR2 (partial +), INSM1 (partial +), RB (+), CK19 (partial +), consistent with thymic cancer. Thymic carcinoma is a rare epithelial tumor of the thymus with an aggressive clinical course. Distant metastasis of thymic cancer, especially lung metastasis, is relatively common, but direct intrabronchial invasion is rare in clinical practice, so attention should be paid to differentiate it from bronchopulmonary cancer.

The article "Guidelines for the Diagnosis and Application of Malnutrition in Adult Patients (2025 Edition)", Volume 105, Issue 13, April 1, 2025, Chinese Medical Journal, top left corner, page 968 "dietary reference intakes (DRIs) 2023 Edition of Chinese Residents recommends that the level of vitamin B1 in urine of adult men is 1.4 mg/d and that of adult women is 1.2 mg/d as the reference standard." It should be "dietary reference intakes (DRIs) 2023 Edition of Chinese Residents recommends that the recommended daily intake of vitamin B1 is 1.4 mg for adult men and 1.2 mg for women." It is hereby corrected.