PMC6119206_01
A large, subepithelial mass lesion with an ulcerated center arising from the second portion of the duodenum just opposite the normal-appearing major papilla.
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F1
After stabilization of his hemodynamics, an esophagogastroduodenoscopy revealed a large, subepithelial mass lesion with an ulcerated center arising from the second portion of the duodenum just opposite the normal-appearing major papilla (Figure 1).
An exophytic solid mass measuring 8 x 5 cm arising from the muscularis propia of the duodenum.
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F2
Endoscopic ultrasound revealed an exophytic solid mass arising from the muscularis propria of the duodenum (Figure 2).
Renal biopsy showing multiple intraluminal clefts and spaces within the glomerulus (arrows) consistent with an atheroemboli and indicative of renal atheroembolic disease.
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F3
Work-up for the acute kidney injury did not show any etiology, and a renal biopsy revealed multiple intraluminal clefts and spaces within the glomerulus consistent with an atheroemboli, indicative of renal atheroembolic disease (Figure 3).
Gross pathology showing an irregular ovoid mass measuring 9 cm in its greatest dimension, with a smooth serosal surface, prominent vasculature, and a 2.5 x 1.5 cm central ulcer (arrow).
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F4
Gross pathology revealed a tan-pink irregular ovoid mass measuring 9 cm in its greatest dimension, with a smooth serosal surface, prominent vasculature, and a 2.5 x 1.5 cm central ulcer (Figure 4).
Microscopic examination showing atherosclerotic changes of large submucosal blood vessels with multiple intraluminal clefts and spaces (arrows) consistent with atheroemboli (40x magnification).
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F5
Microscopic examination revealed spindle-cell neoplasm with no cytologic atypia or mitosis; however, there were atherosclerotic changes of large submucosal blood vessels with multiple intraluminal clefts and spaces consistent with atheroemboli (Figure 5).