Thymic rebound hyperplasia

Thymic rebound hyperplasia is considered a from of true thymic hyperplasia.


In periods of bodily stress the thymus may acutely shrink to 40% of its original volume (depending on the severity and duration of the stress). During the recovery phase it can grow back to its original size or even larger (up to 50% larger). This "rebound effect" is known as thymic rebound hyperplasia. It typically takes the thymus 9 months to return to its original size 1.

Examples of acute stress events that can trigger thymic atrophy and later rebound include: 

  • pneumonia
  • corticosteroid therapy
  • radiation therapy
  • chemotherapy
  • surgery
  • burns
  • post-chemotherapy 10-25% will undergo rebound hyperplasia, usually occurring within 2 years of treatment 2   

Rebound hyperplasia is typically seen in children, but can also occur in adults 2.

Radiographic features


Thymic rebound hyperplasia typically shows diffuse enlargement, a fine mixture of fat and lymphoid tissue, a smooth contour, and normal vessels 2.  


The normal thymus is typically barely visible on PET. However, in rebound hyperplasia it show intense FDG uptake. This can lead to confusion, and misdiagnosis of lymphoma 3.

Share article

Article information

rID: 25346
System: Haematology
Synonyms or Alternate Spellings:
  • Thymic rebound
  • Rebound thymic hyperplasia

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1: post chemotherapy
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.