PMC7684557_01
Coronal view of a mildly enhanced mass lesion in the duodenum or head of the pancreas, spiral computed tomography scan.
qmj-2020-031-g001.jpg
PMC7684557_01_qmj-2020-031-g001.jpg
fig1
The findings favoreda neoplastic process of the pancreatic head (Figure 1).
Germ cell tumor metastasis in a duodenum biopsy. Note crowded tumor cells with indistinct cell borders and overlapping nuclei arranged in solid and glandular patterns (arrowheads). Most of the nuclei were hyperchromatic and sometimes had smudged chromatin, mitotic figures, hemorrhagic foci, and readily apparent necrosis. Hematoxylin and eosin (H&E) x 400.
qmj-2020-031-g002.jpg
PMC7684557_01_qmj-2020-031-g002.jpg
fig2
The IHC profile result revealed positivity forhuman chorionic gonadotropin (HCG),positivity forepithelial membrane antigen(EMA), weak positivity forplacental alkaline phosphatase(PLAP), negativity for C-Kit (cd117), and negativity forleukocyte common antigen (Figure 2).
Testicular mass. Note the syncytiotrophoblast cells with large, multinucleated cells with large, irregular nuclei. Hematoxylin and eosin (H&E) x 400.
qmj-2020-031-g003.jpg
PMC7684557_01_qmj-2020-031-g003.jpg
fig3
Grossly, the tumor was mainly hemorrhagic and necrotic.Microscopically, there was an admixture of syncytiotrophoblast cells (large, multinucleated cells with large, irregular nuclei) and cytotrophoblast cells (pale cytoplasm with a single large nucleus and prominent nucleolus) and intermediate trophoblasts (larger than cytotrophoblasts) (Figure 3).