Fig. 1

a) Inguinal lymph node fine needle aspiration biopsy showing round to oval cells forming cellular aggregates between lymphocytes (Papanicolaou, 20x) b) In the cell block the aggregates exhibit nuclear molding and “salt and pepper” chromatin (H&E, 14x) c) CK20 positive membrane staining pattern (CK20, 12x) and d) synaptophysin confirm the diagnosis of Merkel cell carcinoma (Synaptophysin, 10x) (Figures are courtesy of Dr. Luciana Carvalho Costa)