case_images: PMC8214893_01
case_images: Photomicrographs of the biopsy. A - Fragmented polypoidal tissue with an invasive tumor arranged in papillary configuration, nests and trabeculae. (H&E, x 40); B and C - Papillae with SMILE like lesion [SIL] displaying full thickness dysplastic stratified epithelial cells with diffuse abundant intracytoplasmic mucin displacing nucleus to periphery. (H&E, x 100 and x200, respectively); D - Intracytoplasmic mucin is highlighted on PAS-AB stain. (x 200).
case_images: autopsy-11-e2021289-gf01.jpg
case_images: PMC8214893_01_autopsy-11-e2021289-gf01.jpg
case_images: gf01
case_images: On microscopy, it showed fragmented polypoidal tissue with papillary folds lined by variably thickened truly stratified epithelial cell layers with a maximum of 20 cell thickness (Figure 1A, B). The stratified layers of epithelial cells exhibited full thickness dysplasia with marked nuclear atypia, hyperchromasia, and increase number of mitotic figures, resembling a high-grade squamous intraepithelial lesion (Figure 1C). PAS-AB highlighted intracytoplasmic mucin in the stratified epithelial cell layers (Figure 1 D).
case_images: Photomicrographs of the biopsy. A - strong membranous positivity for CK 7; B - negative expression for p63; C - high ki67 index; D - nuclear expression for p16. (all pictures x 200).
case_images: autopsy-11-e2021289-gf03.jpg
case_images: PMC8214893_01_autopsy-11-e2021289-gf03.jpg
case_images: gf03
case_images: Furthermore, these cells showed strong nuclear expression for p16, and Ki 67 index was 80% (Figure 3AD).