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We report an unusual presentation of thymic RDD in a 38-year-old female patient, with an anterior mediastinal soft tissue mass identified on computed tomography. Histologically, sections of the thymus demonstrated characteristic RDD features accompanied by a complex microenvironment containing both necrotizing and nonnecrotizing granulomatous inflammation. Immunohistochemical stains revealed diffuse positivity for S-100, CD68, and OCT2 in the lesional histiocytes, with focal cyclin D1 expression and absence of CD1a immunoreactivity. CD20, CD5, and CD3 highlighted surrounding reactive B-cell and T-cell lymphocytes. The patient's postoperative course was unremarkable. Subsequent 3-month surveillance demonstrated no evidence of disease recurrence.<\/jats:p>","DOI":"10.1177\/10668969251361181","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T06:03:41Z","timestamp":1755497021000},"page":"249-254","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Thymic Rosai-Dorfman Disease: A Rare Presentation With Unusual Histopathologic Features"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1746-4624","authenticated-orcid":false,"given":"Ahmed I.","family":"Younes","sequence":"first","affiliation":[{"name":"Emory University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4731-0280","authenticated-orcid":false,"given":"Tiffany","family":"Javadi","sequence":"additional","affiliation":[{"name":"Emory University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-7883","authenticated-orcid":false,"given":"Megan","family":"Dibbern","sequence":"additional","affiliation":[{"name":"Emory University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8861-9980","authenticated-orcid":false,"given":"Sunil","family":"Badve","sequence":"additional","affiliation":[{"name":"Emory University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-03-839753"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.55729\/2000-9666.1032"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.182.2.1820514"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e31824e940d"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4778"},{"issue":"11","key":"e_1_3_3_7_2","first-page":"813","article-title":"Thymic Rosai-Dorfman disease: report of a case","volume":"44","author":"Wang J","year":"2015","unstructured":"Wang J, Liu Y. 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