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One year after this initial presentation, this gentleman developed symptoms of colonic inertia. Western blot was negative for paraneoplastic markers (anti-Hu, Ri, Ma, Yo, CV2/CRMPS and amphiphysin antibodies). Immunochemistry demonstrated nuclear staining of Purkinje cells and brainstem neurons. A repeat chest x ray demonstrated a large mediastinal mass (not evident a year previously). Histology has confirmed a diagnosis of malignant thymoma. This ascociation has not been previously reported.
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