TTN and thymoma: Moreover, a small population of highly potent, AChR and titin reactive T cells generated in the near absence of myoid cells inside a largely AIRE-negative atrophic thymus could become activated after export to the periphery and trigger LOMG, and a pathogenic T cell population derived from an atrophic, myoid cell-poor and AIRE-negative thymus may have accumulated in the periphery over a long period before the outbreak of LOMG, i.e., similar to rare thymoma patients who develop TAMG years after thymoma removal [164].