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. 2018 Jul 6;57(23):3451–3458. doi: 10.2169/internalmedicine.1238-18

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Copyright © 2018 by The Japanese Society of Internal Medicine

The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Figure 1. — Progressive encephalomyelitis with rigidity and myoclonus associated with thymoma, with subsequent generalized edema. a) Laryngoscopy immediately after transfer to our hospital showing moderate bilateral vocal cord paralysis with mild pharyngeal edema (arrowheads) and hypersalivation. b) Bilateral vocal cord paralysis with median fixation developed subsequently. Edema (arrowheads) and hypersalivation are still present. c) After thymectomy, the vocal cord paralysis resolved completely. d) Thoracic enhanced computed tomography (CT) showing a thymoma (arrow). e) Chest CT five months after thymectomy, showing massive bilateral pleural effusions (arrows). f) Abdominal CT showing ascites (arrow) and subcutaneous edema (arrowheads).