Early adenocarcinoma mixed with a neuroendocrine carcinoma component arising in the gastroesophageal junction: A case report

Figure 2 Histological findings of poorly differentiated adenocarcinoma mixed with a neuroendocrine carcinoma component. A: Submucosal esophageal glands (arrow) were observed, indicating the distal esophageal location (× 20); B: The area defined by the white rectangle in Figure 2A was enlarged and showed the mixture of moderately (left) and poorly (right) differentiated adenocarcinomas (× 100); C: Adenocarcinoma with a neuroendocrine carcinoma (NEC) component arose in the cardiac mucosa (× 20); D: The area in the black rectangle in Figure 2C exhibited a mixture of adenocarcinoma (right) with NEC (left; × 100); E: The area defined by the black rectangle in Figure 2A was enlarged and demonstrated glandular dysplasia with goblet cells (× 100); F: CDX2 was weakly immunoreactive in moderately differentiated adenocarcinoma and immunonegative in poorly differentiated adenocarcinoma (× 100); G: Mucin 5AC was diffusely immunopositive in poorly differentiated adenocarcinoma and focally immunopositive in moderately differentiated adenocarcinoma (× 100); H: Synaptophysin was diffusely immunopositive in NEC, but immunonegative in adenocarcinoma (× 100); I: The Ki-67 proliferative index was approximately 90% for both the adenocarcinoma and NEC components (× 100); J: p53 was diffusely immunopositive for the adenocarcinoma and NEC components (× 100). All controls stains were adequate.