Fig. 2

Histopathology of the left cervical mass shows features of non-seminomatous germ cell tumor. Cytology and histopathology of bone marrow (BM) shows features of acute megakaryoblastic leukemia. a An open biopsy sample of the left cervical mass shows immature teratoma (arrow 1), columnar epithelium (arrow 2), and immature mesenchymal components (arrow 3) [hematoxylin and eosin staining (H.E.)., 200×] and (b) yolk sac tumor-like components (arrow 4) (H.E., 200×). c Immunohistochemically, the yolk sac tumor-like components are weakly positive for alpha-fetoprotein (AFP) (100×) and (d) strongly positive for Glypican-3 (100×). e BM smear reveals many large blasts with nuclear and cytoplasmic blebs (Giemsa staining, 1000×). f Blast cells are negative for myeloperoxidase. g BM biopsy shows increased blast cells (H.E., 400×). h Immunohistochemically, blast cells show strong cytoplasmic positivity for von Willebrand factor (400×)