Cytoplasmic vacuoles: Clue in the fine‐needle aspiration diagnosis of melanoma

Chen, Liansong; Raza, Anwar; Simental, Raul G.; Iverson, Kiva T.; Cobb, Camilla J.

doi:10.1002/dc.23018

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…Multinucleation is a frequent feature, with some series suggesting their presence in 100% of cases. 15 The presence of multinucleated tumor cells showed no predilection by site aspirated but was statistically more likely in aspirates where the predominant cell type was epithelioid over spindled (Fig. 9).…”

Section: Nuclear Features and Placementmentioning

confidence: 94%

“…15,25 In the study by Chen et al, 15 cytoplasmic vacuoles were found in 83% of cases, all on air-dried smears, regardless the cell types. The potential origin of these vacuoles has been investigated with electron microscopy.…”

Section: Cell Shape and Cytoplasmic Characteristicsmentioning

confidence: 97%

“…Chen et al 15 reported that 22% of their diagnoses of melanoma had no known primary at the time of diagnosis. The preaspiration probability of finding a melanoma is also altered based on the site to be aspirated.…”

Section: Clinical Historymentioning

confidence: 99%

“…Eccentric placement of the nucleus is reported as a relatively common diagnostic criterion and may be noted in more than 70% of cases. 15 While normal plasma cells should not pose much of a mimic, certainly malignant plasma cells pose a possible pitfall.…”

Section: Nuclear Features and Placementmentioning

confidence: 99%

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Cytologic Diagnosis of Metastatic Melanoma

Lindsey¹,

Ingram²,

Bergeron³

et al. 2015

Pathology Case Reviews

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Despite surveillance and public awareness, the incidence of melanoma is increasing. Frequently, fine needle aspiration is employed for the diagnosis of metastatic disease, and aspirate material is used for cytogenetic and molecular studies to guide treatment options. The pairing of a weighty diagnosis and the numerous morphologic variants of melanoma can make the cytologic evaluation disquieting. We present some of our experiences and a brief review of the literature to provide helpful diagnostic clues to this malignancy. The clinical history is foremost, although fine needle aspiration of metastatic melanoma is diagnostic prior to identification of the primary lesion in up to a fifth of cases. Given the history of melanoma, pulmonary and subcutaneous nodules that yield no disease should be suspected false negatives. The smearing pattern is usually one of poorly cohesive cells. Frankly malignant, spindled, and epithelioid cell shapes are most common, and cytoplasmic vacuoles, if dutifully sought on Romanowsky stained specimens, can usually be found. The telltale feature of melanin production, while diagnostic, is only present in half of cases. Finally, eccentric placement of the nucleus, nucleoli, and nuclear pseudoinclusions are accessory features. Numerous morphologies of melanoma are possible, but careful consideration of the clinical history, smearing pattern, and nuclear and cytoplasmic features provides guiding diagnostic clues.M elanoma affects more than 800,000 individuals in the United States alone. Furthermore, the reported incidence is increasing despite the decreasing incidences of other common cancers. In the face of improved public awareness, early detection, and aggressive therapy, the morbidity and mortality remain staggering.The understanding of the pathogenesis of melanoma is growing rapidly, which has resulted in significant advancement in diagnosis and treatment of this malignant neoplasm. 1-4 Numerous genomic alterations have been identified in melanomas, and the prevalence of these alterations may differ by the subtype of melanoma as well as by the age of patients. 1 BRAF mutations are of special note because of their relatively higher prevalence in melanoma. Studies showed that at least 40% of melanomas harbor BRAF mutations; among them, the most common mutation is substitution of the valine residue with glutamine at codon 600 (V600E) with a distance second being substitution of the valine with lysine (V600K). 5 Identification of these mutations plays a vital role in the diagnosis, prognosis, and treatment of melanoma. Inhibitors to key enzymes in BRAF pathway are undergoing clinical trials, and the results are promising. 5,6 The diagnosis of primary superficial melanocytic lesions is usually made on tissue obtained by punch biopsy, shave biopsy, or elliptical excision. Fine-needle aspiration (FNA) has very limited role in the diagnosis of the primary lesions except in rare unusual situations. However, the recognition of melanoma is of great importance in the setting of FNAs performed on pa...

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Section: Nuclear Features and Placementmentioning

confidence: 94%

Section: Cell Shape and Cytoplasmic Characteristicsmentioning

confidence: 97%

Section: Clinical Historymentioning

confidence: 99%

Section: Nuclear Features and Placementmentioning

confidence: 99%

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Cytologic Diagnosis of Metastatic Melanoma

Lindsey¹,

Ingram²,

Bergeron³

et al. 2015

Pathology Case Reviews

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“…Malignant melanoma metastases are frequently diagnosed by FNA cytology . The diagnosis is usually relatively straightforward when the aspirates show abundant cellularity with predominance of single tumor cells with obvious cytologic features of malignancy, prominent macronucleoli, binucleation, nuclear eccentricity, and nuclear pseudoinclusions.…”

mentioning

confidence: 99%

Balloon cells in metastatic melanoma

Saharti

Isaila

Mudaliar

et al. 2017

Diagnostic Cytopathology

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Funding information: No source of funding to declare. K E Y W O R D S balloon cell melanoma, cytology, fine needle aspiration, clear cell neoplasms A 42-year-old male patient presented to an outside hospital for right pleuritic chest pain. Physical examination revealed left supracervical, axillary, and bilateral inguinal lymphadenopathy and a 1-cm irregularly wileyonlinelibrary.com/journal/dc Diagnostic Cytopathology. 2017;45:828-831.

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Cytologic diagnosis of metastatic melanoma by FNA: A practical review

Ronchi

Montella

Marino

et al. 2021

Cancer Cytopathology

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Malignant melanoma (MM) is a highly aggressive neoplasm with a growing worldwide incidence. It is not uncommon that the disease is already metastatic at the time of the first diagnosis. Regional lymph nodes and skin are the first and most common metastatic sites, followed by distant visceral sites (lungs, liver, and central nervous system) and bone. In this clinical setting, fine-needle aspiration (FNA) often represents the first diagnostic approach. FNA is a useful tool to obtain a rapid and accurate diagnosis, in conjunction with ancillary techniques and molecular analysis, as recommended by recent guidelines.The aim of this review was to describe the cytomorphology, immunocytochemical tools, and molecular tools used for the diagnosis of MM metastases on FNA. Cancer Cytopathol 2021;0:1-12.

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Cytoplasmic vacuoles: Clue in the fine‐needle aspiration diagnosis of melanoma

Cited by 8 publications

References 19 publications

Cytologic Diagnosis of Metastatic Melanoma

Cytologic Diagnosis of Metastatic Melanoma

Balloon cells in metastatic melanoma

Cytologic diagnosis of metastatic melanoma by FNA: A practical review

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