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Fig. 2 | Journal of Medical Case Reports

Fig. 2

From: Extensive rhabdomyosarcomatous differentiation in recurrent low-grade urothelial carcinoma of the bladder after transurethral resection: a case report

Fig. 2

Pathological specimens of the resected neoplastic tissue. a–e Pedunculated polyp. f Papillary lesion. a, f Hematoxylin and eosin staining. b–d Immunohistochemical staining. e Fluorescence in situ hybridization using a dual-color break-apart probe for anaplastic lymphoma kinase. The 5′ end of the ALK gene was labeled with Vysis SpectrumGreen, and its 3′ end was labeled with Vysis SpectrumOrange (Abbott Molecular, Des Plaines, IL, USA). The pedunculated polyp consisted mainly of a sarcomatous component with a spindle cell–like appearance, which was characterized by severe nuclear pleomorphism and mitotic activity. Some strap- and racket-shaped cells with eosinophilic elongated cytoplasm were present in a dispersed manner (a). Spindle-like cells were positive for vimentin (b) but negative for cytokeratins recognized by AE1/AE3 (c) and anaplastic lymphoma kinase (d). Rearrangements and copy number gain of the ALK gene were not detected by fluorescence in situ hybridization. A total of 94% of tumor cells showed pseudo-color signals (yellow color, arrowheads) without deletion of red signals (e). The papillary lesion was a low-grade, non-invasive urothelial carcinoma without necrosis (f)

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