Journal of Datta Meghe Institute of Medical Sciences University

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 16  |  Issue : 2  |  Page : 371--372

Metastatic melanocarcinoma – Cytomorphological patterns


Reetika Garg, Arvind Bhake, Anil Agrawal 
 Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India

Correspondence Address:
Dr. Reetika Garg
Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Sawangi (M), Wardha - 442 001, Maharashtra
India

Abstract

Introduction: The cytodiagnosis of melanocarcinoma achieved on Fine Needle Aspiration Cytology is cytomorphologically dicey at metastatic site. This is due to various morphologies achieved by melanocarcinoma as observed in histopathological examination. Therefore, it becomes imperative for cytopathologist to know about cytomorphological patterns observed at the diagnosis of melanocarcinoma. More so when melanocarcinoma is amelanotic and the clinical evidence of primary melanocarcinoma in the skin and other places is absent. Aim and Objectives: The present poster describes the experience with the cytomorphological patterns and diagnosis of melanocarcinoma, where the clinical evidence of presence of growth of melanocarcinoma in skin at any body site was absent. Materials and Methods: Fine needle aspiration done in 15 cases from metastatic sites, slides prepared were processed conventionaly. Result and Conclusion: It was observed that the certain cytomorphological features and typified cytomorphological arrangements in the presence of melanin containing cells or even amelanotic cells is enough characterizing melanocarcinoma which is described in the poster.



How to cite this article:
Garg R, Bhake A, Agrawal A. Metastatic melanocarcinoma – Cytomorphological patterns.J Datta Meghe Inst Med Sci Univ 2021;16:371-372


How to cite this URL:
Garg R, Bhake A, Agrawal A. Metastatic melanocarcinoma – Cytomorphological patterns. J Datta Meghe Inst Med Sci Univ [serial online] 2021 [cited 2022 Jun 30 ];16:371-372
Available from: http://www.journaldmims.com/text.asp?2021/16/2/371/328452


Full Text



 Introduction



Melanocarcinoma (MC) may secondarily involve virtually any tissue and visceral structures in the body[1]The metastatic promiscuity of MC is thought of vertical phase of local growth of cutaneous MC[2]The MC when presented as a cutaneous lesion on many occasions is surgically removed as a matter of small growths on the soul of feet or at any other cutaneous sites by the surgeons inadvertently thinking it to be differential benign growth unsuspected of MC[3]Over a period of time, patients report their surgeons with the nodular growth at the same site or lymphadenopathies or distant cutaneous nodules without evidence of primary site tumor[4]These patients are often subjected to fine-needle aspiration cytology (FNAC) of enlarged lymph nodes or the nodules without any suspected clinical diagnosis of MCThe cytomorphological characterization of the cells and their patterns can help the cytopathologist at the diagnosis of MC with pigments or without pigmentsThe present study describes the experience with 15 such cases from archives of cytopathology at Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, over 4 years.

Aim and objective

The present poster describes the cytomorphology of MC at the metastatic site when the primary site of excision of tumor is without the evidence of growth.

 Materials and Methods



A total of 15 cases were included in the study with its clinical details recordedThe inclusion criteria were the cytodiagnosis of MC on FNAC of enlarged lymph nodes or subcutaneous nodules without evidence of cutaneous MC at the time of hospital consultation but with the history of local excision of the lesion in the pastFNAC was carried out by conventional methods, and aspirates were processed for May–Grünwald–Giemsa (MGG) and Papanicolaou stainThe cytodiagnosis of metastatic MC was made by standard references over the topicThe evaluation of cytomorphological patterns of the cell placement, cellular type, and cell characters was assessed.

 Results



Fifteen cases (11 males and 4 females)Age: Youngest – 23 years and eldest – 67 years (mean age = 43 years)Distribution of lymph nodes and nodules.

Ten cases of inguinal lymph nodeOne case of internal iliac lymph node (ultrasound guided)One case of axillary lymph nodeThree cases of popliteal nodules.Cytomorphological characterization

The most common pattern of cell placement was dissociated or loosely followed by microtissue fragments, pseudospindle cell sheaths, and pseudoglandular arrangements (rare)Cells are chiefly round polygonal in shape followed by spindle-shaped cells followed by pleomorphic population of cells and small cellsNulcear character-enlarged nuclei mostly centrally placed without significant pleomorphism but with prominent nucleoli. Nuclear pseudoinclusion was rarestCytoplasmic melanin was present but not in plenty; however, occasional cell in the cell sheath contains plenty of melanin or background melanin-containing macrophagesBinucleate cells were observed as banal cytomorphological featuresPap stain was more depictive of MC characters of that of MGG stain.

 Discussion



Not many studies in literature deal with the cytodiagnosis of metastatic MC in the absence of known primary of MC are reported in literatureThe present study shares some similar observations with that of Lindsey et al.'s study[1]

 Conclusion



The cytodiagnosis of metastatic MC on FNAC in the absence of known primary is a unique cytopathologic challenge which a cytopathologist should apprehendThe presence of typified and previously described characters can unravel the diagnosis of metastatic MC impacted by previous history of excision of primary site tumor whose histopathology is unknown.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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2Yin J, Lloydd R. Metastatic melanoma-a case report of rare cyto-morphologic variant in fine needle aspiration specimen. N Z J Med Lab Sci 2014;68:28.
3Saqi A, McGrath CM, Skovronsky D, Yu GH. Cytomorphologic features of fine-needle aspiration of metastatic and recurrent melanoma. Diagn Cytopathol 2002;27:286-90.
4Wick MR, Gru AA. Metastatic melanoma: Pathologic characterization, current treatment, and complications of therapy. Semin Diagn Pathol 2016;33:204-18.