PMC3335533_01
Haematoxylin and eosin-stained sections of the tumour, as the presenting metastasis seen within the lymph node ((a) and (b), 10x and 20x, resp.) and the subsequent resection of the fallopian tube ((c) and (d), 10x and 20x, resp.).
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fig1
The axilllary node was excised under general anaesthesia, and pathology revealed a metastatic, high-grade, poorly differentiated tumor (Figure 1). Histology showed this to be extensively involved by a malignant high-grade Mullerian serous carcinoma with identical morphology to that found in the excised lymph node (Figure 1).
(a) Coronal maximum-intensity projection PET image shows abnormally increased FDG uptake within the left axillary lymph node (arrowhead) and within the right side of the pelvis (arrow). (b) Axial fused PET-CT image shows FDG-avid mass within the right adnexa of the pelvis, separate from the bladder (arrow).
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fig2
A positron emission tomography-computed tomography (PET-CT) scan revealed a number of areas of high uptake, including the right pelvis, the left para-aortic region, and 2 small areas in the liver (Figure 2).
Crisp staining of tumour in the lymph node and the Fallopian tube with CK7 ((a) and (b)) and negative staining for CK20 for the same tumour at both sites ((c) and (d)).
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fig3
Staining for CK7 was positive in both tissue samples, but negative for cytokeratin 20 (CK20) (Figure 3).
Membrane and cytoplasmic staining of tumour in the lymph node and the Fallopian tube with AE1/AE3 ((a) and (b)), Ca125 ((c) and (d)), and p53 ((e) and (f)).
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fig4
The tumour in both the Fallopian tube and lymph node showed the same immunohistochemical profiles, CK7 positive, cytokeratin(CK)20 negative, cytokeratin AE1/AE3 positive, CA125 positive, and p53 positive (Figure 4).