CASE N°44 – Epithelioid Melanoma, Lymph Node metastases

Clinical History:

Age: 50

Sex: Female

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.

Image:

cytological speciemen: Right inguinal lymph node, FNA

IMG_7277

IMG_7257

IMG_7276

composit pap1

compositi pap 2

Cytological Report:

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.

Discussions:

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.

References:

Stefan E.Pambuccian Ricardo H.Bardales. Lymph Node Cytopathology. Essentials in Cytopathology Series Editor Dorothy L.Rosenthal. Springer. 146, 180

 

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