PMC4967671_01
(a) At the time of diagnosis diffuse peritoneal fluid in the abdomen and peritoneal implants are presented through the CT scan. (b) Pleural effusion on the left (progressive disease) presented after the third cycle of Capecitabine/Oxaliplatin chemotherapy.
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Computed tomography of the thorax and abdomen revealed a minimal pleural effusion of the left hemithorax, diffuse peritoneal fluid in the abdomen, and peritoneal implants (Figure 1(a)). However, just before the fourth cycle he developed right pleural effusion with accompanying moderate dyspnea (Figure 1(b)).
(a) The testicular parenchyma is infiltrated by neoplastic signet-ring cells (hematoxylin-eosin x200). (b) Tumor cells exhibit positivity for mucin stains (arrows). (c) Immunohistochemically the tumor cells were positive for cytokeratin 20 (arrows).
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Microscopical examination of multiple tissue sections taken from the grossly described foci showed the presence of a poorly differentiated carcinoma composed of signet-ring cells (Figure 2(a)). By histochemical stains (PAS, Alcian Blue) a large amount of mucin was demonstrated in the cytoplasm of tumor cells (Figure 2(b)). TTF-1, and Melan A (Figure 2(c)).