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35 years male with duodenal lesion, multiple hepatic modules and cervical vertebral lesion - hpe and IHC for interpretation

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Paraganglioma mets

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Primary Duodenal Malignancy with Metastasis to Liver & Vertebrae. Possibilities are : Malignant Extraadrenal Pheochromocytoma/ Paraganglioma of Duodenum with mets/ Multiple Syndromic Paragangliomas. Malignant Gangliocytic Paraganglioma metastasizing to liver & vertebrae. Metastatic lesions may show predominantly a single component of tumor proper, as in this case, showing the epithelioid neuroendocrine portion without the spindle neural & ganglionic constituents. IHC : S100, highlighting the sustentacular cells, surrounding the zell ballen clusters of neuroendocrine cells. Other IHCs, suggested are NEM like Chromogranin & Synaptophysin. For GPG : Additional NF can be used.

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Smear shows nesting or alveolar pattern . Round to oval cell with prominant nucleolus and intra cytoplasmic hyalinazation seen.overall impression it is neuroendocrine tumour MULTIPLE PHEOCHROMOCYTOMAS D/d PARAGANGLIOMA S100 ihc highlighting sustentacular cells.

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dd. Pheochromocytoma ...Paraganglioma ...NEC tumor. sug. ihc...S100 ......... Synaptophysin Chromogranin

Multiple Pheochromocytomas ? syndromic Association IHC S 100 Highlighting The Sustentacular cells

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NET likely Synoptophysin and Chronogranin stain

Paraganglioma, s100

Paraganglioma mets

Agree with Dr.Sachin Shah Sir

angiomatous lesion

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