Malignant gangliocytic paraganglioma of the duodenum with distant metastases and a lethal course

Figure 5 Immunohistochemical analysis of the lesions in the duodenum, lymph nodes and pelvic cavity. The epithelioid cells were positive for cytokeratin (AE1/AE3) (A) and chromogranin A (B). The spindle-shaped cells were diffusely positive for S-100 protein (C), and ganglion-like cells were positive for synaptophysin (D). Ki-67 index was low in either epithelioid cell areas (E) or spindle-shaped cell areas (F). A-D: Immunohistochemical staining with original magnification × 400.