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Fig. 2 | BMC Gastroenterology

Fig. 2

From: Highly proliferative anal neuroendocrine carcinoma: molecular and clinical features of a rare, recurrent case in complete remission

Fig. 2

Photomicrographs of routine stained and immunohistochemical preparations of the small cell anal neuroendocrine carcinoma (ANEC). All images are magnified × 400 unless otherwise specified. a. Routine hematoxylin-eosin stain of the primary ANEC. The tumor is shown with solid growth and a monotonous appearance with only mild atypia. Note the squamous cell epithelium of the anal canal to the left. b. Routine hematoxylin-eosin stain highlighting the prominent nuclear molding, a feature of the small cell phenotype. c. Routine hematoxylin-eosin stain displaying a regional lymph node metastasis of the ANEC. Magnification ×100. d-g. Immunohistochemical analyses of the primary ANEC, displaying widespread immunoreactivity towards chromogranin A (d), synaptophysin (e), P16 (f) and a Ki-67 index of 80% (g). h. Regional, subcutaneous metastasis two years later displaying absent chromogranin A immunoreactivity. The same tumor was consistently positive for synaptophysin (data not shown). j. Same subcutaneous recurrence with a Ki-67 index of 90%

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