case_images: PMC3347623_01
case_images: A pair of neoplastic cells (upper left) shows scant cytoplasm, irregular nuclear contours, visible small nucleoli, and a possible inter-cellular 'window'. The cytoplasmic eosinophilia of the neoplastic cells contrast with the cytoplasmic basophilia of the larger reactive mesothelial cell (lower right) (Wright stain, x1000)
case_images: CJ-9-9-g001.jpg
case_images: PMC3347623_01_CJ-9-9-g001.jpg
case_images: F1
case_images: This dyshesive, polymorphous population of cells was most easily appreciated in the Wright-stained cytospin preparations [Figure 1], where the cells were rounded-to-ovoid, and ranged from small (mean, 18 mum) to large (mean, 22 mum) in size.
case_images: (a, b) Neoplastic cells (arrows) intermixed with reactive mesothelial cells. Note the eccentric location of the nuclei of neoplastic cells. (c) Tight 3D cluster of small undifferentiated tumor cells. (d) Multilobated / multinucleated, large, pleomorphic tumor cell with dense cytoplasm (a, b. Wright stain, c, d. Papanicolaou stain, all images original magnification, x1000)
case_images: CJ-9-9-g002.jpg
case_images: PMC3347623_01_CJ-9-9-g002.jpg
case_images: F2
case_images: Large, pleomorphic cells, measuring up to 30 mum, were also present [Figure 2].
case_images: (a, b) Cell block findings showing neoplastic cells admixed with reactive mesothelial cells and lymphocytes. Note the hyperchromatic nuclei and prominent nucleoli of the neoplastic cells. (c, d) Immunoperoxidase studies for cytokeratin AE1 / AE3 and myogenin show lack of tumor cell staining for CK and nuclear positivity for myogenin. Mesothelial cells show the opposite staining pattern. (a,b: Hematoxylin and Eosin, c,d: Immunoperoxidase stains, all images original magnification, x1000)
case_images: CJ-9-9-g003.jpg
case_images: PMC3347623_01_CJ-9-9-g003.jpg
case_images: F3
case_images: Cell-block sections showed pleomorphic tumor cells, with high nucleocytoplasmic ratio, coarse hyperchromatic nuclei, and prominent nucleoli [Figures 3a and 3b]. Immunoperoxidase stains performed on the cellblock preparation showed that the neoplastic cells were positive for muscle-specific actin and myogenin [Figure 3d], but were negative for cytokeratin AE1/AE3 [Figure 3c].