Mediastinal pathology and the contributions of Dr. Juan Rosai

Multilocular Thymic Cyst in a Patient with Untreated HIV/AIDS: Case Report and Review of the Literature

BACKGROUND

Multilocular thymic cysts (MTCs) in adults with human immunodeficiency virus (HIV) are rarely reported.

CASE PRESENTATION

We describe a case of symptomatic MTC in a male with untreated HIV. A presumptive diagnosis was established based on radiographic imaging and biopsy. Pathologic diagnosis and exclusion of malignancy were ultimately confirmed the following thymectomy. In conjunction with starting antiretroviral therapy, the patient recovered well post-operatively with a resolution of his presenting symptoms.

CONCLUSION

Our case report and review of the literature serve to highlight MTCs as an important clinical entity occurring in persons with HIV.

Thymic carcinomas and thymic neuroendocrine tumors: a tribute to Dr. Juan Rosai

Throughout his career, Dr. Juan Rosai greatly impacted our understanding of mediastinal tumors, both as a scientist and as a teacher. This review highlights his manifold contributions in the field of thymic carcinomas and thymic neuroendocrine tumors from a historical perspective.

The contributions of Juan Rosai to testicular pathology with personal remembrances

The authors summarize their personal interactions with someone for whom they had unbounded admiration, Dr. Juan Rosai. This varied from daily review of cases, to sharing the platform at meetings, being under his tutelage as an author, and co-directing postgraduate courses. These all highlighted the remarkable knowledge of medicine Dr. Rosai had, imparting as he did diagnostic pearls and remarks on the literature including the history of our discipline, often laced with a well-honed sense of humor. The contributions he made to the pathology of the testis are then considered beginning with his role in highlighting a tumor, at the time not particularly well publicized, spermatocytic seminoma. He wrote two major papers on it, one on standard clinical and pathologic aspects, and one on its ultrastructure. The first was associated with his diligent investigation of a prior paper reporting an unusually high number of malignant examples of this tumor but on review that was explained by their representing malignant lymphoma. The organizational skills of Dr. Rosai, and attention to detail, were second to none and shown perhaps most notably with his organizing many courses, but they were also illustrated early in his career when he moderated a symposium on germ cell tumors of the testis which laid the framework for the classification and nomenclature of premalignant lesions. Finally, his almost career-long interest in the entity he codiscovered, Rosai-Dorfman disease, was associated with his reporting testicular involvement by that disorder in his later years. This giant figure in pathology will stand forever in the top tier with other greats who have contributed to the field.