Neck Mass -- Unknown Primary Tumor

Electron Microscopy:
The main, and unusual, ultrastructural feature was the countless microvillus-like cytoplasmic extensions projecting from the cell surface and projecting into and filling intercellular spaces (Fig. 4 and 5). These were relatively long and narrow, but quite variable in diameter. No occludens-type junctions or desmosomes were evident. Nuclei were somewhat irregular in profile and contained one or more fenestrated nucleoli (Fig. 4 and 5). Moderate amounts of rough endoplasmic reticulum were present in most tumor cells (Fig. 4).
Figure 3. The tumor cells have moderate amounts of cytoplasm containing many profiles of RER. Many long microvillus-like projections arise from the cell surface as seen in the upper middle part of this micrograph. Figure 4. Cross-sections of microvillus-like surface projections of variable diameter fill the intercellular spaces. No desmosomes, tight junctions or glandular lumens are evident. The nucleolus is distinct.

Diagnosis & Discussion