Liver involvement in the course of thymoma-associated multiorgan autoimmunity: The first histological description

To the Editor:Thymoma-associated multiorgan autoimmunity （TAMA） is a rare paraneoplastic syndrome described in patients with thymoma and characterized by multiorgan failure and graft-versus-host disease （GVHD） like pathology affecting the skin,the gastrointestinal tract,and the liver.To date,only 21 cases are reported in literature [1],with some patients presenting gastrointestinal and hepatic manifestations,mainly colitis,diarrhea,and abnormal liver enzymes,but the hepatic involvement has not been histologically characterized yet.In the present study,we describe for the first time that liver involvement in a patient affected by TAMA resembles GVHD.