Merkel cells and Merkel cell tumors. Ultrastructure, immunocytochemistry and review of the literature

Abstract

Certain monomorphic cellular tumors that occur in the dermis have been called trabecular carcinomas or Merkel cell tumors. Forty-six cases have been reported to date and the literature on these is reviewed here, with six additional cases reported. Cytologic features include sparse cytoplasm, dispersed chromatin with inconspicuous nucleoli in round nuclei and many mitoses. Trabeculae and pseudorosettes may be identified. Electron microscopy is required for definitive diagnosis. Like normal Merkel cells, tumor cells contain electron-dense granules (80-200 nm), 10 mm filaments and desmosomes. Filament-rich cytoplasmic spikes were found in four tumors. These resemble corresponding protrusions of normal Merkel cells and have not been described in other APUDomas.