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A systematic Medline review summarizes knowledge on true thymic hyperplasia, rebound thymic hyperplasia, thymic follicular hyperplasia, and lymphoepithelial-sialadenitis-like thymic hyperplasia, defining histology-based diagnostic boundaries. Entities differ by architecture, age distribution, immunemediated features, and autoimmune or lymphoma associations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/thymic-hyperplasias-in-practice-clinical-context-histological-clues-and-management-implications/464633/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/thymic-hyperplasias-in-practice-clinical-context-histological-clues-and-management-implications/464633.png","ImageObject",300,407,{"name":92,"@type":93},"Emma Wilson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What defines thymic hyperplasia in this review?","Question",{"text":112,"@type":113},"Thymic hyperplasia refers to benign conditions involving enlargement of the thymus or hyperplasia of lymphoid follicles that are typically not prominent in a normal thymus.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do true thymic hyperplasia and rebound thymic hyperplasia differ clinically?",{"text":117,"@type":113},"They preserve the organ’s fundamental architecture and lack association with autoimmunity, but differ in age distribution and clinical context.",{"name":119,"@type":110,"acceptedAnswer":120},"What is the key histological and clinical distinction of thymic follicular hyperplasia and LESA-like thymic hyperplasia?",{"text":121,"@type":113},"Thymic follicular hyperplasia reflects an immunemediated process strongly linked to early-onset myasthenia gravis and shows germinal-center formation within thymic lobes. LESA-like thymic hyperplasia involves epithelial–lymphoid proliferation with architectural distortion, frequent cystic changes, and notable associations with systemic non-myasthenic autoimmune diseases and thymic mucosa-associated-lymphatictissue lymphoma.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},464633,1790825322,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Review  \nThymic Hyperplasias in Practice: Clinical Context, Histological Clues, and Management Implications  \nStefan Porubsky   \nAcademic Editor: Yasushi Shintani  \nReceived: 24 November 2025  \nRevised: 21 December 2025  \nAccepted: 25 December 2025  \nPublished: 27 December 2025  \nCopyright: © 2025 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \nInstitute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; [stefan.porubsky@unimedizin-mainz.de](stefan.porubsky@unimedizin-mainz.de)  \nSimple Summary  \nThymic hyperplasia refers to several benign conditions in which the thymus becomes enlarged or develops histological changes. These conditions can look similar but differ greatly in who they affect, why they occur, and what they mean for patient care. This review brings together current knowledge about the main types of thymic hyperplasia to clarify how they can be distinguished under the microscope and in clinical practice. By improving the ability to differentiate between these conditions, this review article aims to support more accurate diagnoses, and guide appropriate follow-ups.  \nAbstract  \nBackground and Objective: Thymic hyperplasias constitute a heterogeneous group of primarily non-neoplastic conditions characterized by either enlargement of the thymic parenchyma or the proliferation of lymphoid follicles. Differentiating these entities is crucial, as they exhibit significant differences in their epidemiology, clinical associations, and implications for patient management. This review aims to synthesize the current knowledge on true thymic hyperplasia, rebound thymic hyperplasia, thymic follicular hyperplasia, and thymic hyperplasia with lymphoepithelial sialadenitis-like features, and to delineate their diagnostic boundaries in histology. Methods: A systematic literature review of the Medline database was conducted, encompassing all publications available up to November 2025 . The search terms included thymic hyperplasia, true thymic hyperplasia, rebound thymic hyperplasia, thymic follicular hyperplasia, and lymphoepithelial-sialadenitis-like thymic hyperplasia. Studies concerning the histopathological, radiological, and clinical presentations as well as reference works concerning age-related thymus size and weight were included. Limitations stem from the scarcity of systematic investigations and heterogeneity of the available studies. Results: Thymic hyperplasia encompasses biologically diverse entities unified solely by their benign nature, yet distinguished by distinct histological patterns and clinical scenarios. True thymic hyperplasia and rebound hyperplasia preserve the organ’s fundamental architecture and lack association with autoimmunity; however, they differ in age distribution and clinical context. Thymic follicular hyperplasia reflects an immunemediated process, strongly linked to early-onset myasthenia gravis, and is characterized by germinal-center formation within thymic lobes. Lymphoepithelial-sialadenitis-like thymic hyperplasia, by contrast, represents an epithelial–lymphoid proliferation with pronounced architectural distortion, frequent cystic changes, and notable associations with systemic non-myasthenic autoimmune diseases as well as thymic mucosa-associated-lymphatictissue lymphoma. Conclusions: Overall, clinical history, serological data, imaging, and detailed histopathology remain indispensable for differentiating thymic hyperplasias, some of which necessitate further systemic evaluation due to their association with autoimmune diseases or lymphomas.  \nKeywords: thymic hyperplasia; true thymic hyperplasia; rebound thymic hyperplasia; lymphofollicular thymic hyperplasia and lymphoepithelial-sialadenitis (LESA) like thymic hyperplasia  \n1. Introduction  \nBenign tumorous processes of the ant","cbCainlf4VTLBLXL","https://ap.wps.com/l/cbCainlf4VTLBLXL","pdf",8696188,15,"English","# Simple Summary\n# Abstract\n# 1. Introduction\n## Benign processes and definition of thymic hyperplasia\n## Age-adjusted thymus weight and regression models\n# Tables (1-3)\n## Thymus weight by age (under 16 years)\n## Thymus weight by age (over 16 years)\n## Regression equations for thymus weight","[{\"question\":\"What defines thymic hyperplasia in this review?\",\"answer\":\"Thymic hyperplasia refers to benign conditions involving enlargement of the thymus or hyperplasia of lymphoid follicles that are typically not prominent in a normal thymus.\"},{\"question\":\"How do true thymic hyperplasia and rebound thymic hyperplasia differ clinically?\",\"answer\":\"They preserve the organ’s fundamental architecture and lack association with autoimmunity, but differ in age distribution and clinical context.\"},{\"question\":\"What is the key histological and clinical distinction of thymic follicular hyperplasia and LESA-like thymic hyperplasia?\",\"answer\":\"Thymic follicular hyperplasia reflects an immunemediated process strongly linked to early-onset myasthenia gravis and shows germinal-center formation within thymic lobes. LESA-like thymic hyperplasia involves epithelial–lymphoid proliferation with architectural distortion, frequent cystic changes, and notable associations with systemic non-myasthenic autoimmune diseases and thymic mucosa-associated-lymphatictissue lymphoma.\"}]","Thymic Hyperplasias in Practice - Clinical Context, Histological Clues, and Management Implications | PDF",1790768449,38]