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(A) Two fluorodeoxyglucose positive left inguinal lymph nodes. (B) CT pelvis showing 2 enlarged inguinal lymph nodes: posterior node is 24 × 19 mm, anterior node is 16 × 13 mm. (C) Inguinal lymphadenectomy showing high-grade neuroendocrine carcinoma (hematoxylin & eosin staining, 400× magnification). (D) Immunohistochemical staining for CK20 showing perinuclear “dot-like” staining, characteristic of Merkel cell carcinoma (400× magnification).
