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Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas

Melanoma is an aggressive neoplasm, and early diagnosis can reduce mortality in such patients. Diagnosis may be delayed in amelanotic tumors. We present one such case, a 35-year-old lady with a rapidly growing mass over the right angle of mandible. Fine-needle aspiration cytology was done, and smear...

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Autores principales: Mondal, Santosh Kumar, Mondal, Palash Kumar, Dutta, Sujit Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349013/
https://www.ncbi.nlm.nih.gov/pubmed/25745288
http://dx.doi.org/10.4103/0970-9371.151134
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author Mondal, Santosh Kumar
Mondal, Palash Kumar
Dutta, Sujit Kumar
author_facet Mondal, Santosh Kumar
Mondal, Palash Kumar
Dutta, Sujit Kumar
author_sort Mondal, Santosh Kumar
collection PubMed
description Melanoma is an aggressive neoplasm, and early diagnosis can reduce mortality in such patients. Diagnosis may be delayed in amelanotic tumors. We present one such case, a 35-year-old lady with a rapidly growing mass over the right angle of mandible. Fine-needle aspiration cytology was done, and smears showed discretely arranged large epithelioid cells with high N:C ratio, prominent single to multiple nucleoli. Occasional binucleated and multinucleated tumor giant cells were also noted. Poorly differentiated carcinoma, high-grade non-Hodgkin lymphoma, amelanotic melanoma, and pleomorphic sarcoma were included as differential diagnoses. Immunocytochemistry (ICC) revealed Melan-A/MART-1 positivity in some cells and S-100 positivity in most tumor cells. Desmin, pancytokeratin, and leukocyte common antigen were negative. Based on cytomorphological features and ICC findings, a diagnosis of epithelioid variant of amelanotic melanoma was rendered. Later on, true cut biopsy and histologic examination of excised specimen and adjunct immunohistochemistry with positive Melan-A and S-100 confirmed the diagnosis.
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spelling pubmed-43490132015-03-05 Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas Mondal, Santosh Kumar Mondal, Palash Kumar Dutta, Sujit Kumar J Cytol Case Report Melanoma is an aggressive neoplasm, and early diagnosis can reduce mortality in such patients. Diagnosis may be delayed in amelanotic tumors. We present one such case, a 35-year-old lady with a rapidly growing mass over the right angle of mandible. Fine-needle aspiration cytology was done, and smears showed discretely arranged large epithelioid cells with high N:C ratio, prominent single to multiple nucleoli. Occasional binucleated and multinucleated tumor giant cells were also noted. Poorly differentiated carcinoma, high-grade non-Hodgkin lymphoma, amelanotic melanoma, and pleomorphic sarcoma were included as differential diagnoses. Immunocytochemistry (ICC) revealed Melan-A/MART-1 positivity in some cells and S-100 positivity in most tumor cells. Desmin, pancytokeratin, and leukocyte common antigen were negative. Based on cytomorphological features and ICC findings, a diagnosis of epithelioid variant of amelanotic melanoma was rendered. Later on, true cut biopsy and histologic examination of excised specimen and adjunct immunohistochemistry with positive Melan-A and S-100 confirmed the diagnosis. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4349013/ /pubmed/25745288 http://dx.doi.org/10.4103/0970-9371.151134 Text en Copyright: © Journal of Cytology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mondal, Santosh Kumar
Mondal, Palash Kumar
Dutta, Sujit Kumar
Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
title Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
title_full Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
title_fullStr Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
title_full_unstemmed Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
title_short Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
title_sort cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349013/
https://www.ncbi.nlm.nih.gov/pubmed/25745288
http://dx.doi.org/10.4103/0970-9371.151134
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