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. 2023 Feb 13;9:23. doi: 10.1186/s40792-023-01605-y

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© The Author(s) 2023

Open AccessThis 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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — Histopathological findings and immunohistochemical staining test. The resected specimen showed a 40 × 30 mm tumor on the descending part of the duodenum slightly more distal to the papilla of Vater, and a white thickening of the duodenal wall was observed on the sectioned surface of the same area (A, B) (red arrow). There was an infiltrative growth of carcinoma cells with a predominant component of well to poorly differentiated tubular adenocarcinoma under the normal duodenal mucosa (C, D). The non-tumor duodenal epithelium is observed in the upper right corner of this image (red arrow), showing the continuous infiltration of the intramucosal hypodense lesion into the submucosal layer of the duodenal epithelium (C). Cancer cells were developing under the duodenal submucosa and infiltrated into the duodenal muscularis propria (D). The immunostaining of the same area showed that MUC5AC, which stained the gastric crypt epithelium, was diffusely positive in the intramucosal and tumor-infiltrated area, whereas MUC6 was negative to partially positive in the mucosa and positive in approximately 50% of the infiltrated area (E, F)