Synchronous seminoma and Langerhans cell histiocytosis with a multilocular thymic cyst: A rare case report

Abstract

A 28-year-old man with an anterior mediastinal mass underwent total thymectomy. The surgical specimen showed multilocular cysts and nodules. On microscopic examination, the cysts were lined by squamoid epithelium, consistent with thymic cysts and tumors showing two different histologic features were identified. One tumor component was composed of sheets of monotonous, oval-to-round nuclei with pale cytoplasm and indistinct cell borders. The other tumor component comprised sheets of grooved cells admixed with eosinophils. Immunohistochemical analysis revealed different staining patterns in each component: the former was positive for D2-40, c-kit and OCT3/4; and the latter was positive for S100 protein and CD1a. Based on these histopathological and immunohistochemical findings, we diagnosed the tumor as a synchronous seminoma and Langerhans cell histiocytosis along with a thymic cyst. To the best of our knowledge, this is the first case of the coexistence of these lesions in the thymus. Coronavirus Disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) that is associated with several inflammatory and vascular endothelial complications. Ocular vascular occlusive events were reported in COVID-19 patients including both Central Retinal Vein Occlusion (CRVO) and Central Retinal Artery Occlusion (CRAO). We report a case of a 34-years-old patient with right CRVO after 14 days of COVID-19 infection presenting with decreased vision. In addition, we provide a summary of both CRVO and CRAO reported in the literature.