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A–D: Histological and immunohistological findings in patient 4. A: Carcinoma with dense intratumoral lymphocytic infiltrate suggestive of an MSI-H tumor. H&E, magnification, ×10. B: Strong intranuclear staining of MSH2 in the tumor cells. Anti-MSH2, mgnification, ×40. C: MLH1 immunostaining shows only a perinuclear rim-like reaction, but no distinct intranuclear staining. Anti-MLH1, magnification, ×40. D: Complete loss of PMS2 staining in the tumor cell nuclei (arrows).
