Nongynecologic Cytopathology
Shield P. · Ribu D.L.
Log in to MyKarger to check if you already have access to this content.
Buy
FullText & PDF
Unlimited re-access via MyKarger
Unrestricted printing, no saving restrictions for personal use
read more
CHF 38.00 *
EUR 35.00 *
USD 39.00 *
Select
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Learn more
Rent via DeepDyve
Unlimited fulltext viewing of this article
Organize, annotate and mark up articles
Printing and downloading restrictions apply
Start free trial
Subscribe
Access to all articles of the subscribed year(s) guaranteed for 5 years
Unlimited re-access via Subscriber Login or MyKarger
Unrestricted printing, no saving restrictions for personal use
read more
Subcription rates
Select
* The final prices may differ from the prices shown due to specifics of VAT rules.
Article / Publication Details
Abstract
Introduction
Metastatic melanoma (MM) is an uncommon finding in serous effusion specimens with a highly variable cytomorphology.
Methods
We reviewed specimens submitted over a 19-year period to determine (a) the range of cytologic findings in effusion specimens from melanoma patients and b) the cytologic presentation and immunoprofile of MM in effusion specimens.
Results
Of 123 serous effusion specimens from patients with clinical notes of melanoma, 59% were reported negative for malignancy; 16% were reported with a non-melanoma malignancy; 19% MM; and 6% atypical, MM not excluded. Pleural fluids were twice as likely to be reported as MM than peritoneal samples.
Review of 44 cases with confirmed MM showed the most common cytologic pattern was epithelioid. Most (88%) cases contained mainly dispersed plasmacytoid cells, but many (61%) also contained malignant cells arranged in loose groups. Rare cases also had spindle cells, giant bizarre cells, small lymphoid-like cells or cells with large hard-edged vacuoles, mimicking other metastatic malignancies.
MM cases containing predominantly plasmacytoid cells often mimicked reactive mesothelial cells. As well as being composed of cells of similar size, features such as bi- and multi-nucleation, round nuclei, mild anisokaryosis, nucleoli and loose groups were common to both.
Features seen more commonly in MM than reactive cells included large nucleoli (95%) and intranuclear cytoplasmic inclusions (41%), binucleate ‘bug-eyed demons’, and small punctate vacuoles on the air-dried preparations. Pigment was identified in 36% of cases.
IHC is a valuable aid in confirming the cell type. The sensitivity for the most commonly used melanoma markers was: S100 84% (21/25); pan-Melanoma 100% (19/19); HMB45 92% (11/12); Melan A 92% (11/12); SOX10 91% (10/11). No staining was reported for Calretinin (0/21); AE1/AE3 (0/11); EMA (0/16); Ber-Ep4 (0/13).
Discussion:
Effusion specimens from patients with a history of melanoma are frequently (40%) malignant, but almost as likely to be reported as a non-melanoma malignancy as MM. The cytology of MM may mimic a wide range of other metastatic malignancies, but also often closely resemble reactive mesothelial cells. It is important to be aware of this latter pattern so that IHC markers can be applied.
S. Karger AG, Basel
Article / Publication Details
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Comments (0)