Fig. 2

Macroscopic, histological and immunohistochemical images of gangliocytic paraganglioma. a The cut surface of the pancreatic head shows a poorly marginated, yellowish-white tumor, surrounded by the pancreatic tissue without involving the duodenal wall (D) (scale bar = 1 cm). b The tumor is seen adjacent to the pancreatic tissue (right side) (hematoxylin-eosin staining). c The tumor is composed of epithelioid cell nests (arrow), ganglion-like cells (arrowhead), and spindle cells (hematoxylin-eosin staining). d and e In the peripancreatic lymph node, the metastasizing lesion comprises all three cell types (hematoxylin-eosin staining, respectively). f The epithelioid (arrow) and ganglion-like cells (arrowhead) are positive for chromogranin A, whereas the spindle cells are negative. g Only spindle cells are immunoreactive for S-100 protein. h SSTR2A is expressed in the epithelioid cells (arrow) and in a small number of the ganglion-like cells (arrowhead) with complete membranous positivity (score 3)