CTICasesGood Syndrome (Thymoma with Immunodeficiency)
Imaging findings
Chest CT in a patient in his 50s shows a soft-tissue anterior mediastinal mass (thymoma). The airways show marked tracheobronchomegaly (Mounier-Kuhn appearance) with a corrugated trachea and diffuse varicoid bronchiectasis containing tree-in-bud nodules, secondary to recurrent respiratory infections.
Key takeaways
Good syndrome is a rare cause of acquired immunodeficiency characterized by the combination of thymoma, hypogammaglobulinemia, and recurrent bacterial, viral, or opportunistic infections. Recurrent lower respiratory tract infections can lead to severe bronchiectasis and secondary tracheobronchomegaly. Recognizing this association is critical, as treatment of the immunodeficiency with IVIG is necessary to prevent progressive lung damage.
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