Cytologic Features of Metastatic and Recurrent Melanoma in Patients With Primary Cutaneous Desmoplastic Melanoma

Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
American Journal of Clinical Pathology (Impact Factor: 2.51). 12/2008; 130(5):715-23. DOI: 10.1309/AJCPG4QZHLWFXMFJ
Source: PubMed


Desmoplastic melanoma (DM) is a rare subtype of melanoma characterized by malignant spindle cells associated with prominent fibrocollagenous stroma. Primary melanomas may be entirely desmoplastic ("pure" DM) or exhibit a desmoplastic component admixed with a nondesmoplastic component ("combined" DM). The cytologic features of only 5 cases of DM have been reported previously. Fine-needle biopsy (FNB) specimens from 20 recurrent or metastatic lesions in patients with cutaneous DM and 20 recurrent or metastatic lesions from patients with primary cutaneous non-DM were examined and compared. FNB specimens of patients with DM were less cellular (P = .009) and less often exhibited intranuclear cytoplasmic invaginations (P = .008) and mitotic figures (P = .006) than specimens from patients with non-DM. "Combined" DMs were more commonly composed of epithelioid cells (P = .017) and less often contained bizarre/giant tumor cells (P = .010) than did "pure" DMs. Recurrent and metastatic DM has a range of cytologic appearances. Awareness of the cytologic features and careful clinicopathologic correlation will assist in accurate FNB diagnosis.

Download full-text


Available from: John Francis Thompson,
    • "The combined or mixed forms contain desmoplasia in less than 10% of the lesion, with or without heteromorphism (presence of disparate phenotypes in a single neoplasm). The phenotypic elements include: epithelioid cells, Murali et al., 2008,[11] macrophages, smooth muscle, fibroblast-like cells, multinucleated cells, heterotopic bone, lentigo maligna epidermal component, nerve filaments, perivascular lymphoproliferation and focal lymphocytic aggregates. "
    [Show abstract] [Hide abstract]
    ABSTRACT: An elderly female patient was referred to the author for the treatment of a large recurrent pyogenic granuloma in the sole of right foot for a period of 2 years. She underwent excisional surgeries at an outside facility twice in the past. This time, she was treated with wide excision biopsy and the surgical defect was closed with a new technique, the "adjustable suture technique". Histopathology report confirmed "desmoplastic melanoma" with complete marginal clearance. The wound had healed uneventfully. There were no recurrences at 4-year follow-up.
    Indian Journal of Dermatology 04/2010; 55(3):284-9. DOI:10.4103/0019-5154.70706
  • [Show abstract] [Hide abstract]
    ABSTRACT: This frequency synthesis PLL contains a pulse width detection (PWD) mechanism to measure and compare from cycle to cycle the width of up and down error pulses from a phase and frequency detector (PFD). Correction signals are sent to a digitally controlled oscillator (DCO) only if the phase error is small and increasing or large and not getting smaller. The advantages provided by the PWD and DCO are tolerance to process variations, ease of design and analysis, low bandwidth-to-operating frequency ratio (< 0.005), and deterministic error correction. An on-chip decoupling capacitor in the DCO (1OOpF) filters the supply and substrate noise to minimize jitter
    Solid-State Circuits Conference, 1997. Digest of Technical Papers. 43rd ISSCC., 1997 IEEE International; 03/1997
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fine-needle biopsy (FNB) is commonly used in the investigation of patients with a history of melanoma who present with possible metastatic disease. Non-melanoma malignancies (NMM) are common in the general population and not infrequent in patients with melanoma. Such tumors may be difficult to distinguish from metastatic melanoma on FNB. We sought to determine the types of NMMs that occur in melanoma patients, to document the frequency with which they were diagnosed by FNB, and to highlight potential pitfalls in cytologic diagnosis. NMMs occurring in 1416 consecutive melanoma patients who underwent FNB of 2204 clinically suspicious lesions between 1992 and 2002 at a single center were reviewed and analyzed. The sites of FNB included lymph nodes (36.9%), skin and subcutis (25.1%), visceral locations (17.9%), and other sites (20.0%). Of the 1416 melanoma patients investigated by FNB, 116 (8.2%) had a metachronous or synchronous NMM; the NMM was diagnosed by the FNB in 17 (14.7%) patients. The most common NMMs were epithelial tumors (69.4%, most commonly carcinomas of large bowel, breast and prostate) and hematologic malignancies (21.8%). As NMMs are not infrequent in patients with melanoma, they should always be considered in the differential diagnosis of clinically suspicious masses in patients with a history of melanoma, as well as in patients at high risk of melanoma. Careful assessment of the FNB cytologic features and directed use of ancillary studies should enable accurate diagnosis in most cases and facilitate appropriate patient management.
    Melanoma research 03/2010; 20(3):203-11. DOI:10.1097/CMR.0b013e328335058b · 2.28 Impact Factor
Show more