PMC3437277_01
(a) Enhanced computed tomography (CT) revealed a large tumor with internal hypodensity lesion (arrow). (b) Fine needle aspiration cytology (FNAC) of the left large tumor revealed a proliferation of pleomorphic cells with abundant cytoplasm showing clear-cut and atypical features (Papanicolaou staining).
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fig1
Enhanced computed tomography (CT) suggested that the left neck tumor invaded to the left jugular vein and trachea, which displaced to right (Figure 1(a)). FNAC of the left tumor revealed a proliferation of pleomorphic cells with abundant cytoplasm showing clear-cut and atypical features, suggesting undifferentiated malignant cells (Figure 1(b)).
(a) Cut surface at maximal diameter. Upper tumor was close to the submandibular gland (arrowhead). The area of curved line indicates MEC. (b-d) Hematoxylin and eosin (HE) staining (original magnifications: (b) x40 (inset x200), (c), (d) x100). (b) Upper tumor showed cellular islands, in which tumor cells were squamoid while other showed mucin secretion. (c) The site of skin implantation was caused by MEC. (d) MEC and submandibular gland were separated by fibrous tissue.
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The resected specimen had internal necrosis and infiltrated into surrounding tissues, including left submandibular gland, isthmus of the thyroid gland, and dermal tissue along the wounds of cytology (Figures 2(a) and 3(a)). Upper site showed MEC (Figure 2(b)), and lower site showed PC (Figure 3(b)). The tumor cells of MEC were arranged in solid and cribriform pattern, with elongated lumina containing colloid-like material, and had no any association of sclerosis or eosinophils (Figure 2(b)). MEC (Figure 2(c)). MEC and submandibular gland were separated by fibrous tissue (Figure 2(d)).
(a) Cut surface at 1 cm lower from maximal diameter. Each lined area indicates MEC (curved line), PC (dashed line), and poorly differentiated component (dotted line). (b-d) Hematoxylin and eosin (HE) staining (original magnifications: (b), (d) x200, (c) x100). (b) Lower tumor showed typical papillary carcinoma. (c) The boundary of MEC and PC was mixed. (d) Poorly differentiated component was seen in a small area.
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fig3
Upper site showed MEC (Figure 2(b)), and lower site showed PC (Figure 3(b)). The boundary of MEC and PC was mixed (Figure 3(c)). The lower site of MEC contained a little (7 mm in size) poorly differentiated component (Figure 3(d)).