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Metastatic malignant melanoma in liver aspirate: Cytomorphologic distinction from hepatocellular carcinoma
Author(s) -
Parwani Anil V.,
Chan Theresa Y.,
Mathew Seema,
Ali Syed Z.
Publication year - 2004
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.10394
Subject(s) - medicine , pathology , hepatocellular carcinoma , melanoma , fine needle aspiration , papanicolaou stain , epithelioid cell , stain , cytopathology , metastatic carcinoma , carcinoma , cytology , staining , biopsy , immunohistochemistry , cancer , cancer research , cervical cancer
Hepatic metastases of malignant melanoma are not unusual and frequently occur with a clinically long latent period following resection of a cutaneous or ocular primary. Due to its overlapping cytomorphology with a primary hepatocellular carcinoma, diagnostic difficulties may arise on fine‐needle aspiration of these lesions if the clinical history of melanoma is not known. Thirty‐two cases of metastatic melanoma in the liver and primary hepatocellular carcinoma were studied. Aspiration was performed under ultrasound guidance using 22‐gauge spinal needle. Slides were stained with Diff‐Quik and Papanicolaou stain; cell blocks were stained with H&E. A panel of immunostains was performed using conventional methodology. Of the 12 cytologic parameters assessed, the most helpful in making a metastatic melanoma diagnosis were the presence of sheet‐like architecture, plasmacytoid and/or biphasic (epithelioid/spindled cell) morphology, cytoplasmic tails, necrosis, and cytoplasmic melanin‐like pigment. For hepatocellular carcinoma, the presence of trabeculae, perivascular cellular clustering, endothelial wrapping, and centrally located nuclei with granular cytoplasm were helpful features. In selected cases, IPOX studies were critical in arriving at the correct diagnosis. Diagn. Cytopathol. 2004;30:247–250. © 2004 Wiley‐Liss, Inc.