PMC554089_01
Endoscopic photograph of the paraganglioma demonstrating an exophytic tumor whose edges enfold around a central area of necrosis that is actively bleeding.
1477-7819-3-15-1.jpg
PMC554089_01_1477-7819-3-15-1.jpg
F1
She underwent upper gastrointestinal (GI) endoscopy which demonstrated a 3 cm, ulcerated, ampullary mass (figure 1).
Photomicrograph showing areas of the tumor that had an epithelial pattern resembling carcinoid tumor or islet cell tumor. These cells were cohesive, uniform in size and shape with small round uniform nuclei, and formed rosettes, cribriform structures, solid nests and trabecular cords (Hematoxylin and Eosin original magnification x100).
1477-7819-3-15-2.jpg
PMC554089_01_1477-7819-3-15-2.jpg
F2
Histologically, the tumor consisted of a complex neoplastic proliferation that included a component resembling carcinoid or islet cell tumor (figure 2), admixed with a proliferation of spindled neurofibrillary cells and larger polygonal cells demonstrating gangliocytic differentiation (figures 3 and 4).
Photomicrograph showing areas of the tumor that consisted of a proliferation of spindled neurofibrillary cells with admixed larger polygonal ganglionic cells (Hematoxylin and Eosin original magnification x100).
1477-7819-3-15-3.jpg
PMC554089_01_1477-7819-3-15-3.jpg
F3
Histologically, the tumor consisted of a complex neoplastic proliferation that included a component resembling carcinoid or islet cell tumor (figure 2), admixed with a proliferation of spindled neurofibrillary cells and larger polygonal cells demonstrating gangliocytic differentiation (figures 3 and 4).
Photomicrograph showing the ganglionic cells having large round nuclei with chromatin clearing and large central nucleoli. The cytoplasm is abundant and amphophilic staining. The ganglionic cells are admixed with the spindled cells (Hematoxylin and Eosin original magnification x400).
1477-7819-3-15-4.jpg
PMC554089_01_1477-7819-3-15-4.jpg
F4
Histologically, the tumor consisted of a complex neoplastic proliferation that included a component resembling carcinoid or islet cell tumor (figure 2), admixed with a proliferation of spindled neurofibrillary cells and larger polygonal cells demonstrating gangliocytic differentiation (figures 3 and 4).
Photomicrograph showing the focal areas of stromal hyalinization with calcification. Special stains for amyloid were negative (Hematoxylin and Eosin original magnification x200).
1477-7819-3-15-5.jpg
PMC554089_01_1477-7819-3-15-5.jpg
F5
There were areas of stromal hyalinization resembling amyloid, with focal calcification (figure 5).