FNA diagnosis of malignant melanoma-recurrent and metastatic disease

Abstract

We present a case of a 60-year-old woman with multiple right axillary swellings. Patient had a history of lump with pigmentation over back for which she was operated upon. There was also a nodule over resected scar on back. A final diagnosis of malignant melanoma (recurrent and metastatic to axillary lymph nodes) was rendered with the help of fine-needle aspiration cytology (FNAC). Malignant melanomas are the most lethal of cancers of the skin and are notorious for the great variability of cytological presentation. We discuss the role of FNAC in early diagnosis and prognostication of recurrent and metastatic disease.

Figure 1

H&E-stained fine-needle aspiration cytology smear showing the cellular loosely cohesive smear pattern (×10).

Figure 2

Smear showing the round to polygonal cells with large nuclei (often eccentric), prominent nucleoli, occasional binucleate forms and focal intracytoplasmic brown melanin pigment.

Figure 3

Smear showing the melanin pigment in a binucleate tumour cell.

Figure.4

Smears from axillary lymph node also show similar cytological features, though melanin pigment was not clearly appreciated.

Figure 5

Smears from axillary lymph node also show similar cytological features, though melanin pigment was not clearly appreciated.