腮腺肿块病例中通过细针穿刺确诊的恶性黑色素瘤。

IF 1.2 4区 医学 Q4 CELL BIOLOGY
Cytopathology Pub Date : 2024-09-04 DOI:10.1111/cyt.13440
Didem Turcan, Evrim Yilmaz, Berat Acu, Mustafa Fuat Acikalin
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引用次数: 0

摘要

背景:皮肤黑色素瘤是转移到腮腺和相关淋巴结的最常见恶性肿瘤之一。尽管细针穿刺术(FNA)在诊断原发性涎腺肿瘤方面已得到广泛认可,但有关其在诊断转移性病变方面作用的文献却很有限:本研究旨在探讨腮腺肿块病例中通过 FNA 诊断的恶性黑色素瘤的细胞形态学特征:我们介绍了四例病例的临床和细胞形态学结果。采用标准技术进行常规 FNA 活检涂片和细胞块,并使用免疫组化标记物进行鉴别诊断:结果:患者包括三名女性和一名男性,年龄在 54 至 77 岁之间。FNA 活检结果显示,非典型细胞具有大的、高色素的多形性核,其中一些细胞核泡突出。还观察到浆细胞和肿瘤细胞形态。发现大量有丝分裂。免疫组化染色显示,所有病例均呈 HMB-45 和 S100 阳性。还观察到 SOX10、MART-1 和 MITF 阳性。四例患者中有三例在 FNA 诊断时没有黑色素瘤病史或疑似病变。黑色素色素的缺失使诊断变得复杂,但免疫印迹证实了恶性黑色素瘤:结论:通过 FNA 诊断恶性黑色素瘤具有挑战性,尤其是当黑色素瘤发生在不寻常的部位、细胞学结果不明确且无皮肤黑色素瘤病史时。准确诊断需要高度怀疑并使用适当的免疫组化方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Malignant melanoma diagnosed by fine-needle aspiration in cases presenting with parotid mass.

Background: One of the most common malignancies that metastasize to the parotid glands and associated lymph nodes is cutaneous melanoma. Although fine-needle aspiration (FNA) is well established for diagnosing primary salivary gland tumours, there is limited literature on its role in diagnosing metastatic lesions.

Aims and objectives: This study aims to investigate the cytomorphological features of malignant melanoma diagnosed by FNA in cases presenting with a parotid mass.

Materials and methods: We present the clinical and cytomorphological findings of four cases. Conventional FNA biopsy smears and cell blocks were performed using standard techniques and for the differential diagnosis, a panel of immunohistochemical markers was used.

Results: The patients included three females and one male, aged 54 to 77. FNA biopsies revealed atypical cells with large, hyperchromatic, pleomorphic nuclei, some of which exhibited prominent nucleoli. Plasmacytoid and oncocytic morphologies were also observed. Numerous mitotic figures were noted. Immunohistochemical staining showed HMB-45, S100 positivity in all cases. SOX10, MART-1 and MITF positivity were also observed. Three of the four patients had no history or suspected lesions of melanoma at the time of FNA diagnosis. The absence of melanin pigment complicated the diagnosis, but immunostains confirmed malignant melanoma.

Conclusion: Diagnosing malignant melanoma by FNA can be challenging, especially when the melanoma is in an unusual site, cytological findings are ambiguous, and there is no history of cutaneous melanoma. Accurate diagnosis requires a high level of suspicion and the use of appropriate immunohistochemistry.

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来源期刊
Cytopathology
Cytopathology 生物-病理学
CiteScore
2.30
自引率
15.40%
发文量
107
审稿时长
6-12 weeks
期刊介绍: The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.
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