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Presented by Pedram Argani, M.D. and prepared by Shien Micchelli, M.D.
Case 1: 69 year old female with a history of breast cancer now with a uterine cervical mass.
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Question 1 of 1
1. Question
Week 255: Case 1
69 year old female with a history of breast cancer now with a uterine cervical mass. The tumor cells were immunoreactive for CD117, CD56, and CD99.images/1_30_06_1a.jpg
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images/1_30_06_1e.jpgCorrect
Answer: Metastatic melanoma
Histology: This is a small cell malignant neoplasm involving the uterine cervix. The morphology and history suggests Metastatic Lobular Carcinoma, but cytokeratin stains were negative. Tumor cells were diffusely immunoreactive for S100 protein, HMB45, and Melan-A, supporting the diagnosis of Metastatic Melanoma.
Discussion: Metastatic Lobular Carcinoma would label for cytokeratins and typically for estrogen and progesterone receptors. Granulocytic Sarcoma would label for CD45 and CD43, and not express melanocytic markers. Ewing’s Sarcoma would express CD99, but would not express the melanocytic markers identified in this case.
This is a good example of metastatic small cell melanoma. It is wise to remember that Melanoma can have a variety of morphologic patterns which simulate other neoplasms; these include Balloon Cell, Desmoplastic, Spindle, Signet Ring, Rhabdoid, Myxoid, Giant Cell, Epithelioid Cell, Clear Cell, and Small Cell. Immunoreactivity for CD117, CD99, CD10, CD56, CD68, and Factor 13A are recognized to occur in Melanoma.
Reference(s):
– Histopathology 2000;36: 387-402.Incorrect
Answer: Metastatic melanoma
Histology: This is a small cell malignant neoplasm involving the uterine cervix. The morphology and history suggests Metastatic Lobular Carcinoma, but cytokeratin stains were negative. Tumor cells were diffusely immunoreactive for S100 protein, HMB45, and Melan-A, supporting the diagnosis of Metastatic Melanoma.
Discussion: Metastatic Lobular Carcinoma would label for cytokeratins and typically for estrogen and progesterone receptors. Granulocytic Sarcoma would label for CD45 and CD43, and not express melanocytic markers. Ewing’s Sarcoma would express CD99, but would not express the melanocytic markers identified in this case.
This is a good example of metastatic small cell melanoma. It is wise to remember that Melanoma can have a variety of morphologic patterns which simulate other neoplasms; these include Balloon Cell, Desmoplastic, Spindle, Signet Ring, Rhabdoid, Myxoid, Giant Cell, Epithelioid Cell, Clear Cell, and Small Cell. Immunoreactivity for CD117, CD99, CD10, CD56, CD68, and Factor 13A are recognized to occur in Melanoma.
Reference(s):
– Histopathology 2000;36: 387-402.