CASE N°44 – Epithelioid Melanoma, Lymph Node metastases
3 years ago removal of malignant melanoma of the dorsum of the right foot. At follow-up right inguinal lymphadenopathy. It is suggested cyto-histological examination.
cytological speciemen: Right inguinal lymph node, FNA
Cellularity type of lymph node absent. Epithelioid malignant tumor cells isolated and arranged in clusters, characterized by brownish intracytoplasmic pigment.
Positive for malignancy. Cytological finding referable to localization of malignant melanoma.
Approximately 4% of melanomas show axillary, cervical,
and inguinal lymph node metastasis, in decreasing order of
frequency, with occult primary tumor.
Metastatic melanoma may show a monotonous large
cell pattern in smears of fine-needle aspirates of lymph nodes
It may mimic the cytomorphology of any neoplasm,
including lymphoma although metastatic melanoma cells are usually
larger and more pleomorphic. The diagnosis is facilitated by
the clinical history and the demonstration of melanin pigment in
tumor cells or associated histiocytes (melanophages),
but melanin may be entirely absent and the history of melanoma
may not be available.
Stefan E.Pambuccian Ricardo H.Bardales. Lymph Node Cytopathology. Essentials in Cytopathology Series Editor Dorothy L.Rosenthal. Springer. 146, 180