PMC10126381_01
Representative hematoxylin and eosin (h and e) images of the tumor. (a): Focus of epithelial proliferation with stratification, hierarchical branching, and mild nuclear atypia; (b): Nodule composed of spindle cells, abutting serous cyst lining; (c): Focal papillary epithelioid growth pattern within nodule; (d): Nodule with spindle morphology.
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In some foci, comprising greater than 10% of the serous component of the neoplasm, epithelial proliferation and hierarchical branching were noted (Figure 1(a)). Within the wall of the cystic mass, multiple nodules were identified, composed of a spindled and epithelioid proliferation which abutted the serous lining in some areas but did not exhibit a biphasic growth pattern (Figure 1(b)). Focally, the epithelioid cells showed a papillary growth pattern with more marked nuclear pleomorphism (Figure 1(c)). Other nodules were composed of cells with similar nuclear features; however, the cells showed spindled morphology with some fascicular growth pattern with more conspicuous mitotic figures and multiple foci of necrosis (Figure 1(d)). Tumor involving the omentum showed high-grade features and a predominantly spindled morphology, similar to the tumor seen in Figure 1(d).
Immunoprofile of serous cyst lining and anaplastic nodule. (a): Cytokeratin eight shows diffuse reactivity in cyst lining and nodule; (b): p53 shows wild-type reactivity in serous component, but diffuse strong nuclear reactivity in anaplastic nodule; (c): PAX-8 shows diffuse reactivity in cyst lining and nodule; (d): WT-1 shows strong nuclear reactivity in cyst lining but only weak expression in anaplastic nodule.
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Representative images of the immunoprofile are shown in Figure 2.
PMC10126381_02