June 25, 2019
Melanoma is a highly aggressive malignant tumor arising from skin, eye and internal organs. Melanoma frequently metastasizes to lung, liver, the central nervous system, and other diverse sites. Metastasis may be the first clinical presentation in some patients. Melanoma can present with various cytologic patterns including plasmacytoid, undifferentiated, epithelioid, spindle shaped/sarcomatoid, or macrophage-like. The cytoplasm can be delicate, granular or vacuolated. These cytologic features can potentially mimic carcinoma, plasmacytoma/lymphoma, sarcoma, macrophages, or granular cell tumor, among others. Melanin pigment may be present in some cases, with differentials that include lipofuscin pigments, hemosiderin or anthracotic pigment. Diagnostically challenging cases with clinical findings, Diff- Quik and/or Papanicolaou stained FNA smears and touch preps, H&E stained cell blocks/cores, and ancillary studies will be presented.
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