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. 2018 Sep 3;1:131. doi: 10.1038/s42003-018-0137-0

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© The Author(s) 2018

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Case 1, breast carcinoma after sex-mismatched transplantation (male-to-female). a Hematoxylin and eosin (H&E) specimen of the invasive ductal carcinoma. Cancer cells form tubules or nests and infiltrate with involvement of a desmoplastic reaction. A normal mammary duct with an inner epithelial cell layer and an outer layer of myoepithelial cells is observed beside the tumor (black arrow). Scale bar, 200 µm. b α-Smooth muscle actin (αSMA) immunofluorescent in situ hybridization (ImmunoFISH) analysis of chromosomes X and Y performed on the same section as a. Immunostaining for αSMA highlights αSMA(+) spindle cells including cancer-associated fibroblasts (CAFs), pericytes of blood vessels, and myoepithelial cells of mammary ducts (green arrow). αSMA, blue; X, magenta; Y, green; DAPI, gray. Scale bar: 200 µm. c Magnified image of the inset to b. A recipient-derived αSMA(+) stromal cells with spindle-shaped nuclei (SCSSNs) is observed (yellow arrowhead). Compared with the H&E-stained image (a) obtained using a classical optical microscope, more nuclei are observed in this immunoFISH image. This is because this is a confocal microscope maximum intensity projection image of a z-stack; therefore, the nuclei deep in the section that could not be observed using a classical optical microscope could be seen. d Additional image of αSMA ImmunoFISH analysis. Representative donor-derived αSMA(−) SCSSNs are indicated by white arrows and recipient-derived αSMA(+) SCSSNs by yellow arrowhead. αSMA, blue; X, magenta; Y, green; DAPI, gray. Scale bar: 100 µm. e Additional image of αSMA ImmunoFISH analysis. Donor-derived αSMA(+) SCSSN is indicated by yellow arrow. αSMA, blue; X, magenta; Y, green; DAPI, gray. Scale bar: 100 µm