In early March 2024, we lost a giant in anatomic pathology: Virginia Anne LiVolsi, MD, died unexpectedly on March 7, 2024, as she was getting ready to come into work that day. Dr LiVolsi will be sorely missed by her Penn Medicine (Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania) colleagues, staff, and trainees. She will be remembered not only for her outstanding surgical pathology expertise, but also for her mentoring and life lessons. We were fortunate to have her in our lives for more than 40 years at Penn.
As many know, Dr LiVolsi was a world-renowned endocrine pathologist. We don’t believe that anyone practicing medicine can mention the word “thyroid” without thinking of her, and this will stand for many years to come. However, Dr LiVolsi’s knowledge of pathology extended far beyond her endocrine expertise. She was also considered one of the world’s best surgical pathologists, with novel contributions not only to endocrine pathology, but also to gynecologic pathology, breast pathology, and salivary gland pathology, to name a few. Her contributions to surgical pathology were immense, from papers and books to lectures and involvement in a number of national/international pathology societies, but we feel that one of the most important aspects of Dr LiVolsi’s outstanding career was her mentorship of practicing pathologists and pathology trainees. Her prior mentees are in academia, industry, and community practices throughout the world and include medical school deans, department chairs, and division/section directors.
Virginia Anne LiVolsi, MD
Many might not be aware of Dr LiVolsi’s sense of humor. She loved a good laugh and she lived for being in the spotlight of our annual holiday videos—some of which you may have heard about (imagine Dr Virginia LiVolsi dressed as Marilyn Monroe singing “Thyroids are a Girl’s Best Friend” in the Hospital of the University of Pennsylvania Pathology gross room). She loved a good joke, and years ago we played one on her. In the early ’90s, we had a case of tall cell variant presented at one of our consensus conferences being run by John Tomasewski, MD. Virginia was not there, but when I described the tall cell variant, I accidentally stated that the cells were 2 to 3 times as wide as they were tall, and my colleague Leslie Litzky, MD, astutely said that was more like the “squat cell variant,” and this was echoed by John. This was at the time of the United States and Canadian Academy of Pathology abstract submission. Our group wrote an abstract entitled “The Squat Cell Variant of Papillary Thyroid Carcinoma” and printed it on a United States and Canadian Academy of Pathology abstract submission form, putting Dr LiVolsi as the senior author. When she got back into the office, we showed her the abstract, which she thought we had actually submitted. She was quite relieved that it was a joke. She never mentioned it again, but I happened to be chatting with a colleague at another institution more than 15 years later, and they mentioned that on a grand rounds visit to their institution Dr LiVolsi had told them about our joke abstract submission of the “Squat Cell Variant of PTC,” and we had a good laugh.
Many of us who had the privilege to work with Dr LiVolsi greatly benefitted from her mentoring—from how to view a specimen to how to write a report and how to communicate with clinicians to provide the most comprehensive patient care. Her favorite aspect of surgical pathology was frozen sections, and the lessons we learned from her were immense—such as the time to educate a surgeon regarding the proper use of frozen sections (not during the frozen section itself!) and the careful wording of frozen section diagnoses. And most importantly, “Frozen section should not be used to diagnose primary thyroid neoplasms!” Dr LiVolsi’s mentorship spans generations of pathologists. In recent years, Dr LiVolsi had several residents ask if they could sit with her to review consults and her attending-only service cases; this practice grew into a “mini fellowship” with residents lined up for the next several years.
Dr LiVolsi was a valued colleague, mentor, and friend. It is hard to review a case these days and know that you will be unable to share it with her. One of Dr LiVolsi's most endearing traits was her continued interest in learning new things and how excited she would be to see a case that she had never seen before. She had a common approach in that she would indicate this was a type of case that she had not quite seen before but “I expect we will see it reported in next week’s ‘Pathology Journal of the Month.’” I remember she indicated that although she knew that salivary gland acinic cell carcinoma could become high grade, she actually never diagnosed one. It is ironic that while I took over her cases after her passing, we had not only 1, but 2 such cases that were initially assigned for her review. Hopefully she is looking down smiling because she would have seen those cases, and I hope she is smiling because we are continuing in our practice to honor her legacy.
Dr LiVolsi was a greatly esteemed and beloved colleague, diagnostician, mentor, and role model. Her insights into the field and her legacy of mentorship will continue to impact future generations. It is hard to put into words how much we miss her, but we are all extremely grateful for the essential lessons she taught us and for the incredible impact she had on our careers.