The authors herein describe the morphologic and immunohistochemical features of normal Merkel cells as well as the clinicopathologic findings of Merkel cell carcinoma in cats. Merkel cells were characterized as vacuolated clear cells and were individually located in the epidermal basal layer of all regions examined. Clusters of Merkel cells were often observed adjacent to the sinus hair of the face and carpus. Immunohistochemically, Merkel cells were positive for cytokeratin (CK) 20, CK18, p63, neuron-specific enolase, synaptophysin, and protein gene product 9.5. Merkel cell carcinoma was detected as a solitary cutaneous mass in 3 aged cats (13 to 16 years old). On cytology, large lymphocyte-like cells were observed in all cases. Histologic examinations of surgically resected tumors revealed nests of round cells separated by various amounts of a fibrous stroma. Tumor cells were commonly immunopositive for CK20, CK18, p63, neuron-specific enolase, and synaptophysin, representing the characteristics of normal Merkel cells. 29 Merkel cells are located in the hair discs (Haarscheiben), hair follicles, interfollicular epidermis, and glabrous skin in humans. 20,21 However, a previous study reported that Merkel cells were absent in hair follicles in the body skin of mice and present only in the epidermal hair discs and whisker hair follicles.20 Most Merkel cells possess synaptic connections with the enlarged terminal endings of myelinated sensory nerve fibers. Neurotransmitters or neuromodulators are secreted from Merkel cells through exocytosis in response to mechanical stimuli to the skin, thereby suggesting a function of Merkel cells as a mechanoreceptor of tactile sensation. 10,12 Difficulties have been associated with identifying Merkel cells on routine hematoxylin and eosin (HE)-stained sections.
20Merkel cells express various neuropeptides and neuroendocrine markers, such as neuron-specific enolase (NSE), chromogranin A, synaptophysin, and protein gene product 9.5 (PGP9.5) in humans, making them identifiable by immunohistochemistry. 7,9,17,24 Cytokeratin (CK) 20 is assumed to be the most specific marker for Merkel cells in the skin of humans and mice.
5In humans, CK20-positive Merkel cells are distributed in the palms and hairy skin of embryos and fetuses and in the ventral midline of adults (the incision line of a routine autopsy). 14,20 To the best of our knowledge, the presence and distribution of CK20-positive Merkel cells have not yet been examined in normal cat skin.Merkel cell carcinoma is a rare cutaneous tumor showing both epithelial and neuroendocrine differentiation. Although Merkel cell carcinoma is considered to arise from Merkel cells, recent findings indicated that primitive epidermal stem cells or early B cells were the origin of Merkel cell carcinoma. 13,27,30 Only 3 cases of feline Merkel cell carcinoma have been reported to date and were diagnosed by examining biopsy samples. Two cases were accompanied by pulmonary and lymph node metastases showing malignant behaviors, 22,23 while the