PMC6614785_01
Paraganglioma with organoid/nested (Zallballen) pattern; nests separated by vascularized, thin fibrous septa (H&E, original magnification x40).. Lower left inset:. Large polygonal tumor cells with granular cytoplasm, pleomorphic and bizarre nuclei with prominent nucleoli; occasional (arrow) intranuclear inclusions are present (H&E, original magnification x400).. Lower right inset:. Vascular invasion (arrow) in paraganglioma (H&E, original magnification x40).
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PMC6614785_01_gr1.jpg
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The pathologic evaluation revealed a 2.5 cm paraganglioma that was completely excised; a rare focus of vascular invasion was noted (Fig. 1). The mass had large polygonal tumor cells with granular cytoplasm and pleomorphic to bizarre nuclei, with rare intranuclear inclusions (Fig. 1).
Tumor cells with diffuse granular cytoplasmic staining for antibody to chromogranin (immunohistochemical stain, original magnification x200).. Lower right inset:. Occasional (arrow) sustentacular cells at the periphery of tumor cell nests, highlighted by antibody to S-100 (immunohistochemical stain, original magnification x100).
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PMC6614785_01_gr2.jpg
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The tumor cells showed diffuse and strong immunoreactivity for antibodies to chromogranin, synaptophysin and neuron specific enolase (NSE); rare sustentacular cells were highlighted by S-100 immunostain (Fig. 2).