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Background. The thymus is a limphoepithelial organ located mostly in the anterior mediastinum and, for a smaller part, in the neck. The gland is particularly developed in the fetus and in children, while it shrinks in young adults following an involution process. The computed tomographic appearance of normal and abnormal thymus and its age-related changes have been described. However, there are little quantitative data regarding thymic morphology at the mature age and the value of thymic measurements. Objective. The aim of the present study was to evaluate the normal CT attenuation of a thymus in normal patients of a different age. Materials and methods. Using computed tomography and ultrasonography (US) thymic morphology in 88 normal patients was analyzed, taking into account its appearance at the mature age and its dimensions. Results. The study confirmed the previously reported age-related growth and subsequent involution of the normal thymus. In more than half the patients beyond the age of 40, total fatty involution of the gland occurred. The comparison of sonograms and CT scans showed that sonography could not help differentiate the normal-size thymus from surrounding fatty tissue in the patients beyond the age of 20. Conclusion. Recognition of normal variation in CT appearance of a thymus may prevent false-positive diagnosis of neoplasm. CT may be better than US in distinguishing between thymus replaced by fat and mediastinal fat in the patients beyond the age of 20.
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