case_images: PMC3420371_01
case_images: Computed tomography scan showing the lymph nodes metastases of Merkel cell carcinoma.
case_images: CRIM.PATHOLOGY2011-840575.001.jpg
case_images: PMC3420371_01_CRIM.PATHOLOGY2011-840575.001.jpg
case_images: fig1
case_images: Cervical ultrasonography and computed tomography scan suggested enlarged cervical lymph nodes (Figure 1).
case_images: The dermis shows a proliferation of lobules in a lymphoid background (H&E, original magnification x40).
case_images: CRIM.PATHOLOGY2011-840575.002.jpg
case_images: PMC3420371_01_CRIM.PATHOLOGY2011-840575.002.jpg
case_images: fig2
case_images: The excised cutaneous specimen showed a dermal carcinomatous proliferation with features of LEL carcinoma, characterized by a nonneoplastic prominent lymphocytic infiltrate intermingled with a poorly differentiated epithelial proliferation with syncytial appearance (Figures 2 and 3).
case_images: Tumor cells are pleomorphic with vesicular nuclei and prominent nucleoli (H&E, original magnification x200).
case_images: CRIM.PATHOLOGY2011-840575.003.jpg
case_images: PMC3420371_01_CRIM.PATHOLOGY2011-840575.003.jpg
case_images: fig3
case_images: The excised cutaneous specimen showed a dermal carcinomatous proliferation with features of LEL carcinoma, characterized by a nonneoplastic prominent lymphocytic infiltrate intermingled with a poorly differentiated epithelial proliferation with syncytial appearance (Figures 2 and 3).
case_images: The lymph node is massively infiltrated by a proliferation of monotonous basophilic cells (H&E, original magnification x100).
case_images: CRIM.PATHOLOGY2011-840575.004.jpg
case_images: PMC3420371_01_CRIM.PATHOLOGY2011-840575.004.jpg
case_images: fig4
case_images: Cervical lymph node was massively infiltrated by a dense carcinomatous proliferation suggesting neuroendocrine differentiation, and it was made of monomorphous small basophilic cells with a very fine chromatin and minimal cytoplasm dispersed in a scanty stroma (Figure 4).
case_images: Tumor cells are positive for neurofilament (immunohistochemistry x400).
case_images: CRIM.PATHOLOGY2011-840575.005.jpg
case_images: PMC3420371_01_CRIM.PATHOLOGY2011-840575.005.jpg
case_images: fig5
case_images: Immunohistochemical stains of the cutaneous tumor and lymph node metastases showed immunoreactivity for neurofilament (Figure 5), chromogranin, synaptophysin, and a characteristic dot-like perinuclear staining for cytokeratin 20 (Figure 6).
case_images: Tumor cells are positive for cytokeratin 20 with a dot-like staining (immunohistochemistry x400).
case_images: CRIM.PATHOLOGY2011-840575.006.jpg
case_images: PMC3420371_01_CRIM.PATHOLOGY2011-840575.006.jpg
case_images: fig6
case_images: Immunohistochemical stains of the cutaneous tumor and lymph node metastases showed immunoreactivity for neurofilament (Figure 5), chromogranin, synaptophysin, and a characteristic dot-like perinuclear staining for cytokeratin 20 (Figure 6).