Thymoma with immunodeficiency (also known as "Good syndrome") is a rare disorder that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and thymoma (usually benign) may develop almost simultaneously.Most reported cases are in Europe, though it occurs globally. Dr. Robert Good was first to describe the association between thymoma and hypogammaglobulinemia in 1954. Much remains to be understood about its pathogenesis.