case_images: PMC5996408_01
case_images: T1 MRI images of malignant PEComa metastasis exerting mass effect in both (a) sagittal and (b) axial views.
case_images: CRIPA2018-5749421.001.jpg
case_images: PMC5996408_01_CRIPA2018-5749421.001.jpg
case_images: fig1
case_images: The tumor was noted in the temporal lobe of the brain, orbital bones, and lumbar spine (Figures 1 and 2).
case_images: Initial CT imaging of the abdomen and pelvis with and without contrast for evaluation of the inguinal mass in (a) coronal, (b) sagittal, and (c) axial views demonstrating superficial extension and involvement of anterior abdominal wall by mass and (d) axial view demonstrating a proximal cross-sectional view of the mass that is not extending to the superficial skin.
case_images: CRIPA2018-5749421.002.jpg
case_images: PMC5996408_01_CRIPA2018-5749421.002.jpg
case_images: fig2
case_images: The tumor was noted in the temporal lobe of the brain, orbital bones, and lumbar spine (Figures 1 and 2).
case_images: Histology and immunochemistry of malignant PEComa. (a) Malignant cells in a concentric arrangement around blood vessels (H&E, 100x). (b) Epithelioid cells with granular light eosinophilic cytoplasm and oval nuclei with small nucleoli (H&E, 400x). (c) Melan-A demonstrates salient cytoplasmic immunoreactivity, supporting melanocytic phenotype (Melan-A (MART-1), 400x). (d) HMB-45 demonstrates salient cytoplasmic immunoreactivity, supporting melanocytic phenotype (HMB-45, 400x).
case_images: CRIPA2018-5749421.003.jpg
case_images: PMC5996408_01_CRIPA2018-5749421.003.jpg
case_images: fig3
case_images: The predominant pattern was that of the malignant cells concentrically located around hyalinized medium-sized blood vessels (Figure 3).
case_images: Histology and cytology of malignant PEComa. (a) Sheets of polygonal epithelial cells with hyperchromatic nuclei with prominent nucleoli and brisk mitotic activity (H&E, 400x). (b) Epithelioid cell clusters in a hemorrhagic background (Papanicolaou stain, 400x). (c) Medium cellular aspirate in hemorrhagic background (Papanicolaou stain, 400x). (d) Pleomorphic cells with enlarged nuclei with conspicuous nucleoli and light eosinophilic cytoplasm (Papanicolaou stain with oil, 1000x).
case_images: CRIPA2018-5749421.004.jpg
case_images: PMC5996408_01_CRIPA2018-5749421.004.jpg
case_images: fig4
case_images: The less prominent pattern was that of the malignant cells arranged in sheets forming cords or nodules (Figure 4). Occasionally, intranuclear inclusions were noted (Figure 4).