PMC6000770_01
Abdominal CT performed with oral and IV contrast. Appendix is dilated to 1.4 cm in diameter with marked mural thickening and mild adjacent fat stranding, typical of acute appendicitis.
gr1.jpg
PMC6000770_01_gr1.jpg
fig0005
Tomography (CT) scan with contrast demonstrated a 1.4 cm in diameter appendix with marked mural thickening and mild fat stranding typical of acute appendicitis (Fig. 1). The patient underwent a laparoscopic appendectomy.
A: H&E stain highlighting small rosettes (arrows) arranged in clumps, the hallmark of GCC; B: Magnified GCC clusters; C: Mucicarmine stain illustrating extent of GCC infiltration (arrow) into subserosa using basement membrane (arrowhead) as guide; D: Magnified mucicarmine stain displaying mucin distended goblet cells; E: Ki-67 stain with high proliferative index (50-80%); F: Perineural invasion (arrow).
gr2.jpg
PMC6000770_01_gr2.jpg
fig0010
Immunohistochemically (Fig. 2, Fig. 3), the tumor cells stained positive for CDX-2, synaptophysin, chromogranin and CK20.