case_images: PMC6280236_01
case_images: Photomicrographs of the frozen section. ((a), 10x objective) A low magnification of the lesion showing numerous psammoma bodies packed with the tubular nests. ((b), 20x objective) At a larger magnification, the psammoma bodies as well as the cellular morphologies are display with more details. Clusters of rather large cells with abundant foamy cytoplasm and eccentric nuclei were also present (arrow).
case_images: CRIPA2018-8148147.001.jpg
case_images: PMC6280236_01_CRIPA2018-8148147.001.jpg
case_images: fig1
case_images: The entire nodule was frozen, and sections showed small, tightly packed tubules and nests of epithelioid cells in a fibrous background notable for many psammoma bodies (Figure 1).
case_images: Photomicrographs of the permanent section. ((a), 4x objective) At a low magnification, the lesion shows a fibrous background with embedded tumor cells infiltrating the surrounding stroma. There are many psammoma bodies present throughout the tissue. ((b), 40x objective) At a higher magnification, there are tubular structures with hyperchromatic nuclei infiltrated by the inflammatory cells. Also, clusters of larger cells with foamy cytoplasm (arrow) are present.
case_images: CRIPA2018-8148147.002.jpg
case_images: PMC6280236_01_CRIPA2018-8148147.002.jpg
case_images: fig2
case_images: On permanent section, a clearer cytologic assessment showed that the epithelioid cells were relatively small with regular, round nuclei, and even chromatin (Figure 2).
case_images: Photomicrographs of thread-like bridging (20x objective). The arrows point to the thread-like bridging feature of adenomatoid tumor in all three panels. (a) shows the bridges in the upper part and the solid tumor morphology in the lower segment of the photomicrograph stained with hematoxylin & eosin. (b) is calretinin IHC reaction of the cytoplasm and the nuclei, and (c) is PAX8 IHC reaction of the nuclei. Panel (c) has also captured a psammoma body.
case_images: CRIPA2018-8148147.003.jpg
case_images: PMC6280236_01_CRIPA2018-8148147.003.jpg
case_images: fig3
case_images: Thread-like bridging, a typical feature of adenomatoid tumors, was observed in several foci of the lesion (Figures 3(a)-3(c)). Immunohistochemical (IHC) studies revealed positivity for WT1, calretinin (Figure 3(b)), PAX8 (Figure 3(c)), and D2-40 (Figure 4), and negativity for p53, estrogen-progesterone (ER-PR) receptors of the tumor cells.
case_images: Photomicrographs of D2-40 immunohistochemical (IHC) stain. D2-40 IHC is a cell membrane stain and is a specific marker for mesothelial tumors as well as lymphoid endothelial cells and their neoplasms. ((a), 10x objective) The tumor cells as well as the vascular structures show strong reaction. ((b), 40x objective) A cluster of the foamy cells with the intense cell membrane reaction.
case_images: CRIPA2018-8148147.004.jpg
case_images: PMC6280236_01_CRIPA2018-8148147.004.jpg
case_images: fig4
case_images: Immunohistochemical (IHC) studies revealed positivity for WT1, calretinin (Figure 3(b)), PAX8 (Figure 3(c)), and D2-40 (Figure 4), and negativity for p53, estrogen-progesterone (ER-PR) receptors of the tumor cells. The vacuolated cells shared the same immunophenotype (Figure 4).