PMC3994608_01
The computed tomography scan showed lobulating contoured hemorrhagic necrotic tumor (9 cm x 6 cm x 6.5 cm) with peripheral irregular enhancement in lower abdomen and pelvis and some amount of hemoperitoneum in cul-de-sac.
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F1
A computed tomography scan was undertaken and showed a lobulating hemorrhagic tumor (9 cm x 6 cm x 6.5 cm) with hemoperitoneum in the lower abdomen and pelvis (Fig. 1).
On formalin-fixed specimen, multinodular solid masses showed tan gray and fleshy cut surface. Multifocal hemorrhage and necrosis were seen.
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F2
There was multifocal hemorrhages and necrosis (Fig. 2).
Microscopic findings: tumor cells showed characteristic findings of "rhabdoid" cells such as infiltrative border (A: H&E, x200), eccentric nuclei, prominent nucleoli, and characteristic eosinophilic inclusion or globules in abundant cytoplasm (B: H&E, x400) in nested tumor cells. Immunohistochemically neoplastic cells expressed cytokeratin (C, x400), and vimentin (D, x400). Importantly neoplastic cells revealed absence of nuclear expression of INI 1 (E, x200).
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F3
Microscopically nested round to polygonal tumor cells revealed infiltrative borders (Fig. 3A) and each tumor cell showed eccentric nuclei, prominent nucleoli, as well as a characteristic eosinophilic inclusion or globules in the abundant cytoplasm (Fig. 3B). Immunohistochemically neoplastic cells expressed cytokeratin (Fig. 3C), vimentin (Fig. 3D), and epithelial membrane antigen. Importantly neoplastic cells revealed the absence of nuclear expression of INI 1 (Fig. 3E), which was recently discovered as a one of the most important histologic markers of malignant rhabdoid tumors.