PMC3420759_01
Grossly secondarily ulcerated solid nodular gray white tumor mass.
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fig1
On the opening of the ileal lumen, a 2 x 1,5 x 1 cm, secondarily ulcerated, solid, nodular, gray white tumor mass was seen close to the resection margin (Figure 1).
(a) Perivascular tumor cells with clear to slightly eosinophilic granular cytoplasm and round vesicular nuclei, (b) submucosal tumor mass.
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fig2
Histological evaluation demonstrated a tumoral tissue composing nests of round-polygonal epithelioid cells with abundant clear to slightly eosinophilic granular cytoplasm and round vesicular nuclei, located at the periphery of the thin vascular network (Figure 2(a)).  Tumor was secondarily ulcerated and invading submucosa (Figure 2(b)), muscularis propria, and serosa.
SMA positivity in perivascular tumor cells.
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fig3
SMA (Figure 3), HMB45 (Figure 4), Melan-A (Figure 5), CD99, and E cadherin and negative for S100, desmin, CD117, CD34, CD31, AE1/3, EMA, CD10, RCC, CD45, chromogranin A, synaptophysin, ER, PR, cerbB2, cyclin D1, CK20, CK5-6, CK19, bcl2, GCDFP15, MFG, and TTF1 immunohistochemically. So the diagnosis was ileal PEComa.
Cytoplasmic HMB45 positivity in perivascular tumor cells.
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fig4
SMA (Figure 3), HMB45 (Figure 4), Melan-A (Figure 5), CD99, and E cadherin and negative for S100, desmin, CD117, CD34, CD31, AE1/3, EMA, CD10, RCC, CD45, chromogranin A, synaptophysin, ER, PR, cerbB2, cyclin D1, CK20, CK5-6, CK19, bcl2, GCDFP15, MFG, and TTF1 immunohistochemically. So the diagnosis was ileal PEComa.
Melan-A positivity in perivascular tumor cells.
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fig5
SMA (Figure 3), HMB45 (Figure 4), Melan-A (Figure 5), CD99, and E cadherin and negative for S100, desmin, CD117, CD34, CD31, AE1/3, EMA, CD10, RCC, CD45, chromogranin A, synaptophysin, ER, PR, cerbB2, cyclin D1, CK20, CK5-6, CK19, bcl2, GCDFP15, MFG, and TTF1 immunohistochemically. So the diagnosis was ileal PEComa.