The varied presentation of metastatic melanoma in fine needle aspiration cytology of the breast
Ribu, D.L., Shield, P.W., & Bligh, J.F. (2012) The varied presentation of metastatic melanoma in fine needle aspiration cytology of the breast. Cytopathology, 23(4), pp. 256-262.
To identify cytomorphological patterns of metastatic melanoma (MM) in breast fine needle aspiration (FNA) specimens and highlight the differential diagnoses and features most useful in identifying MM.
The clinical, radiological and FNA findings of 16 cases were reviewed. Cytological features evaluated related to cell arrangement, size and shape of cells, nuclear and cytoplasmic features, and the presence or absence of necrosis.
The series consisted of 14 females and two males, ranging in age from 24 to 83 years (mean = 50 years). A previous history of melanoma was available in 12/16 (75%) cases at the time of FNA reporting; however the clinical/radiological impression in 4/16 cases was of a breast cyst. The cases were classified into six morphological variants: classical (8/16), pseudopapillary (3/16), spindle-cell (1/16), melanin-rich (1/16), pleomorphic (2/16) and lymphoma-like (1/16). The varying patterns raised a wide range of differential diagnoses; however, discohesion, binucleation and granular cytoplasm were the major features seen in 94% of all cases. In 14/16 cases (88%), plasmacytoid cells, prominent nucleoli and cytoplasmic vacuolation were identified. Melanin and multinucleation were detected in 44% of cases and intranuclear cytoplasmic invaginations in 63%. Necrosis was present in more than half of the cases (56%).
MM should be considered in the differential diagnosis of breast FNA specimens when atypical cells are seen that present as plasmacytoid cells in a dispersed or pseudopapillary pattern, or as spindle, pleomorphic or pigmented cells. These features, combined with clinical history and immunocytochemistry, may assist in correctly identifying MM and directing optimal treatment.
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|Item Type:||Journal Article|
|Keywords:||melanoma, metastasis, fine needle aspiration, breast|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > ONCOLOGY AND CARCINOGENESIS (111200) > Cancer Diagnosis (111202)
|Divisions:||Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
|Copyright Owner:||Copyright 2011 Blackwell Publishing Ltd|
|Copyright Statement:||This is the peer reviewed version of the following article: Ribu, D.L., Shield, P.W., Bligh, J.F., & , (2012) The varied presentation of metastatic melanoma in fine needle aspiration cytology of the breast. Cytopathology, 23(4), pp. 256-262., which has been published in final form at 10.1111/j.1365-2303.2011.00883.x. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.|
|Deposited On:||24 Nov 2014 22:37|
|Last Modified:||29 Nov 2014 01:17|
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