PMC2808614_01
PMC2808614_02
PMC2808614_03
PMC2808614_04
Histologic finding of the skin biopsy (Case 1), dense infiltration of medium-sized blastoid tumor cells without necrosis or angiocentric growth noted in the upper and mid-dermis without epidermotrophism (H&E stain, A; x100, B; x250).
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F1
In skin biopsy, dense infiltration of tumor cells without necrosis or angiocentric growth was noted in the upper and mid-dermis and occasionally in the dermis to the subcutaneous tissue (Fig. 1).
In Case 3, tumor cells arranged in Homer-Wright type pseudorosette (A; H&E stain, x400) with positivity for terminal deoxynucleotidyl transferase (B; x400).
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F2
Peculiarly, in Case 3, tumor cells were arranged around a central fibrillary core, which was very similar to Homer-Wright type pseudorosettes seen in neuroepithelial tumors (Fig. 2A). Only Case 3 tumor displayed positive reactivity for TdT (Fig. 2B).
Results of immunohistochemical stains. Most of tumor cells strongly express CD56 (A) and CD4 (B) (x400).
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F3
All four tumors were CD4+/CD56+ (Fig. 3).