Microscopic examination revealed monomorphous small round cells with eosinophilic cytoplasm in small aggregates within a fibrous stroma in the subcutis. Numerous mitotic figures, some atypical mitotic figures, and a large number of apoptotic cells were noted. Immunohistochemical staining was positive for chromogranin and synaptophysin, weakly positive for anticytokeratin 20, and negative for anticytokeratin 7. The dermis and subcutis of the tumor were strongly labeled with an AE1/AE3 anticytokeratin mixture. An infused computed tomographic scan showed diffuse hypodensities in the liver, with extensive retroperitoneal lymphadenopathy encasing the aorta and inferior vena cava. Colonoscopy revealed 1 tubular adenoma. The results of a serum chemistry profile, liver function tests, and prostate-specific antigen screening were within the normal range. A complete blood cell count was significant for anemia.
Multiple Subcutaneous Nodules With Unknown Metastases to the Liver—Diagnosis. Arch Dermatol. 2005;141(1):93-98. doi:10.1001/archderm.141.1.93-d