case_images: PMC6159206_01
case_images: Fused 18Fluoro-Deoxy-glucose axial PET CT image demonstrates increased uptake in the left submandibular gland (B). The normal right submandibular gland is shown at this level (A).
case_images: bjrcr.20160127.g001.jpg
case_images: PMC6159206_01_bjrcr.20160127.g001.jpg
case_images: f1
case_images: This detected FDG avid uptake in the left submandibular gland (Figure 1).
case_images: Colour Doppler ultrasound image corresponding to the FDG-avid region on PET-CT. Ill-defined hypoechoic mass within the medial left submandibular gland (calipers), avascular and heterogeneous features those of malignancy though non-specific in differentiating primary from secondary neoplasm.
case_images: bjrcr.20160127.g002.jpg
case_images: PMC6159206_01_bjrcr.20160127.g002.jpg
case_images: f2
case_images: An ultrasound scan confirmed a poorly defined mass within the left submandibular gland suspicious for malignancy (Figure 2).
case_images: Left submandibular gland, H-E, x40.
case_images: bjrcr.20160127.g003.jpg
case_images: PMC6159206_01_bjrcr.20160127.g003.jpg
case_images: f3
case_images: Microscopic appearances (Figures 3 and 4) were compatible with metastatic infiltration of the left submandibular gland from the known moderately differentiated oesophageal adenocarcinoma (CK7 and CDX-2 positive/CK-20 negative on immunohistochemistry).
case_images: Left submandibular gland, CDX-2 immunostain, x40. Core biopsies showing normal salivary gland tissue (Figure 3, arrowed a), and infiltration by a proliferation of irregular glands containing intraluminal mucinous secretion and surrounded by desmoplastic stroma (Figure 3, arrowed b). The tumour cells show diffuse nuclear immunoreaction for CDX-2, which indicates intestinal phenotype shown in the Figure 4, arrowed. The immunohistological features are compatible with metastasis of known moderately differentiated invasive tubular adenocarcinoma of the gastro-oesophageal junction.
case_images: bjrcr.20160127.g004.jpg
case_images: PMC6159206_01_bjrcr.20160127.g004.jpg
case_images: f4
case_images: Microscopic appearances (Figures 3 and 4) were compatible with metastatic infiltration of the left submandibular gland from the known moderately differentiated oesophageal adenocarcinoma (CK7 and CDX-2 positive/CK-20 negative on immunohistochemistry).