Filamentous Inclusions of Unusual Composition and Architecture in a Metastatic Tumor Showing Myoepithelial Differentiation

A hyaline/eosinophilic cytoplasmic inclusion is described in a metastatic tumor occurring in the omentum and bowel of a 32-year-old white woman. The tumor was essentially of round cell type; was positive for cytokeratin, actin, and S-100 protein by immunohistochemistry; and showed desmosomes (maculae adherentes), tonofibrils, modestly developed myofilaments with focal densities, and a basal lamina by electron microscopy. It was therefore interpreted as showing myoepithelial differentiation. Nearly all cells possessed a large, rounded cytoplasmic inclusion that was architecturally unusual, consisting of intermediate filaments intermingled with lattices of fine filaments. The inclusions exhibited an additionally unusual immunohistochemical staining for both cytokeratin and actin. A comparison with cases described in the literature is made.