| CASE REPORT |
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| Year : 2014 | Volume
: 31
| Issue : 4 | Page : 207-209 |
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Cytodiagnosis of epithelioid malignant melanoma (amelanotic) and diagnostic dilemmas
Santosh Kumar Mondal, Palash Kumar Mondal, Sujit Kumar Dutta
Department of Pathology, Medical College, Kolkata, West Bengal, India
Correspondence Address:
Santosh Kumar Mondal
"Teenkanya Complex", Flat 1B, Block, 204 RN Guha Road, Dumdum, Kolkata - 700 028, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9371.151134
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Melanoma is an aggressive neoplasm, and early diagnosis can reduce mortality in such patients. Diagnosis may be delayed in amelanotic tumors. We present one such case, a 35-year-old lady with a rapidly growing mass over the right angle of mandible. Fine-needle aspiration cytology was done, and smears showed discretely arranged large epithelioid cells with high N:C ratio, prominent single to multiple nucleoli. Occasional binucleated and multinucleated tumor giant cells were also noted. Poorly differentiated carcinoma, high-grade non-Hodgkin lymphoma, amelanotic melanoma, and pleomorphic sarcoma were included as differential diagnoses. Immunocytochemistry (ICC) revealed Melan-A/MART-1 positivity in some cells and S-100 positivity in most tumor cells. Desmin, pancytokeratin, and leukocyte common antigen were negative. Based on cytomorphological features and ICC findings, a diagnosis of epithelioid variant of amelanotic melanoma was rendered. Later on, true cut biopsy and histologic examination of excised specimen and adjunct immunohistochemistry with positive Melan-A and S-100 confirmed the diagnosis.
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