1
|
Khan S, Abeer I, Husain M, Jetley S. Cytological Diagnosis of Pilomatrixoma and its Diagnostic Pitfalls. J Cytol 2023; 40:88-94. [PMID: 37388396 PMCID: PMC10305896 DOI: 10.4103/joc.joc_122_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/28/2022] [Accepted: 03/23/2023] [Indexed: 07/01/2023] Open
Abstract
Background Pilomatrixoma (PMX) is a relatively uncommon benign cutaneous neoplasm arising from skin adnexa. It presents as a subcutaneous asymptomatic nodule mostly in the head and neck region and is frequently misdiagnosed by the clinicians. Although easily diagnosed on histopathology, the cytologic features of PMX are less distinctive, depending on the stage and evolution of disease and may mimic other benign or even malignant lesions. Aim To study the cyto-morphological features of this uncommon neoplasm and identify its potential diagnostic pitfalls on fine needle aspiration cytology (FNAC). Material and Methods Archival records of histopathologically diagnosed Pilomatrixoma were analyzed during study period of 2.5 years. Clinical diagnosis, preoperative FNA characteristics, and histopathological details were studied in each case. Cytologic pitfalls resulting in misdiagnosis of PMX cases on FNAC were evaluated in discordant cases. Results The series showed male preponderance, with head and neck being the commonest site. Out of 21 histopathologically proven cases of PMX, cytological correlation was available in 18 cases. A correct cytologic diagnosis of PMX/adnexal tumor was rendered in 13 cases. Erroneous diagnosis was given in 5 cases mainly because of the predominance of one component over the other or non-representative-aspirated material. Conclusion The present study highlights the importance of careful screening of FNAC smears keeping in mind the variability in the relevant cytologic features of PMX and creates awareness about the lesions that can mimic Pilomatrixoma resulting in diagnostic dilemma.
Collapse
Affiliation(s)
- Sabina Khan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Inara Abeer
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Musharraf Husain
- Department of Surgery, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sujata Jetley
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| |
Collapse
|
2
|
Liu CY, Lai FJ, Chang ST, Chuang SS. Diagnostic clues for differentiating Merkel cell carcinoma from lymphoma in fine-needle aspiration cytology. Diagn Cytopathol 2021; 50:E23-E27. [PMID: 34491618 DOI: 10.1002/dc.24872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/09/2022]
Abstract
Nodal fine needle aspiration (FNA) is usually the first procedure in the work-up of malignancy of unknown primary. Merkel cell carcinoma (MCC) is an aggressive cutaneous cancer more common in Caucasians but rare among Asians. It is a diagnostic challenge in evaluating FNA from a metastatic MCC without the knowledge of a current or prior history of skin cancer. We report the case of a Taiwanese male with cervical and axillary masses. The diagnosis of the FNA from the axillary lymph node was lymphoproliferative lesion suspicious for lymphoma. The histopathological evaluation of nodal biopsy revealed a metastatic neuroendocrine carcinoma and the subsequent excision of the right palm tumor confirmed MCC. Retrospective review of the FNA and imprint cytology smears of the nodal biopsy showed nuclear molding, Indian filing and rare cytoplasmic pale bodies, but no lymphoglandular bodies. Cytologically metastatic MCC may mimic small round cell tumor including lymphoma, we consider these three cytological features as additional diagnostic clues for metastatic MCC. In this report, we present the cytologic and pathological features of this metastatic MCC and discuss the differential diagnosis of the cytologic mimickers.
Collapse
Affiliation(s)
- Chih-Yi Liu
- Division of Pathology, Sijhih Cathay General Hospital, New Taipei City, Taiwan.,College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Feng-Jie Lai
- Department of Dermatology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Sheng-Tsung Chang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Nursing, National Tainan Institute of Nursing, Tainan, Taiwan
| | | |
Collapse
|
3
|
Humphreys TR, Shah K, Wysong A, Lexa F, MacFarlane D. The role of imaging in the management of patients with nonmelanoma skin cancer. J Am Acad Dermatol 2017; 76:591-607. [DOI: 10.1016/j.jaad.2015.10.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 10/12/2015] [Accepted: 10/17/2015] [Indexed: 11/17/2022]
|
4
|
Imaging in patients with merkel cell carcinoma. J Skin Cancer 2013; 2013:973123. [PMID: 23476783 PMCID: PMC3580906 DOI: 10.1155/2013/973123] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/04/2013] [Indexed: 12/03/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine tumor of the skin with a mortality rate of approximately 25% (Peloschek et al., 2010). Accurate assessment of nodal involvement in patients with MCC predicts significantly overall outcome (Smith et al., 2012 and Ortin-Perez et al., 2007). Due to the rarity of this highly aggressive disease, only a few imaging reports on MCC were published, and subsequently still to date no accepted imaging algorithm for MCC is available. For primary staging of MCC, general recommendations have included ultrasonography, chest X-ray CT, and MRI, but recent articles show that the use of sentinel node and FDG-PET/PET-CT is gaining more and more importance.
Collapse
|
5
|
A practical update of surgical management of merkel cell carcinoma of the skin. ISRN SURGERY 2013; 2013:850797. [PMID: 23431473 PMCID: PMC3570924 DOI: 10.1155/2013/850797] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 10/30/2012] [Indexed: 01/08/2023]
Abstract
The role of surgeons in the treatment of Merkel cell carcinoma (MCC) of the skin is reviewed, with respect to diagnosis and treatment. Most of the data in the literature are case reports. Surgery is the mainstay of treatment. A wide local excision, with sentinel node (SLN) biopsy, is the recommended treatment of choice. If SLN is involved, nodal dissection should be performed; unless patient is unfit, then regional radiotherapy can be given. Surgeons should always refer patients for assessment of the need for adjuvant treatments. Adjuvant radiotherapy is well tolerated and effective to minimize recurrence. Adjuvant chemotherapy may be considered for selected node-positive patients, as per National Comprehensive Cancer Network guideline. Data are insufficient to assess whether adjuvant chemotherapy improves survival. Recurrent disease should be treated by complete surgical resection if possible, followed by radiotherapy and possibly chemotherapy. Generally results of multimodality treatment for recurrent disease are better than lesser treatments. Future research should focus on newer chemotherapy and molecular targeted agents in the adjuvant setting and for gross disease.
Collapse
|
6
|
Bechert CJ, Schnadig V, Nawgiri R. The Merkel cell carcinoma challenge: a review from the fine needle aspiration service. Cancer Cytopathol 2012; 121:179-88. [PMID: 23225406 DOI: 10.1002/cncy.21237] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 06/09/2012] [Accepted: 06/29/2012] [Indexed: 11/10/2022]
Abstract
Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine carcinoma of the skin that occurs primarily in elderly or immunocompromised patients. For this report, the authors reviewed the diagnostic challenges associated with MCC encountered on their fine-needle aspiration (FNA) service and also conducted an in-depth review of the literature on MCC. A computer search for patients who were diagnosed with MCC by FNA at the authors' institution from 2006 to 2010 was conducted, and 5 patients were selected for cytologic and immunochemical analyses based on their varied and diagnostically challenging clinical presentations. The 5 selected patients had clinical findings commonly associated with MCC, including advanced age (4 of the 5 patients were ages 75-85 years) and a history of previous malignancies (3 of the 5 patients had a history of previous malignancy), and 1 patient was diagnosed with a concomitant low-grade lymphoma. The patients and their disease illustrated the protean clinical presentation of MCC and the clinical and cytologic challenges associated with this neoplasm. The current findings indicate the need for cytopathologists to be aware of the deceptive presentation of this neoplasm and its cytologic and immunochemical features to correctly diagnose this insidious neoplasm.
Collapse
Affiliation(s)
- Charles J Bechert
- Division of Cytopathology, University of Texas Medical Branch, Galveston, Texas 77555-0548, USA
| | | | | |
Collapse
|
7
|
Knoepp SM, Hookim K, Placido J, Fields KL, Roh MH. The application of immunocytochemistry to cytologic direct smears of metastatic merkel cell carcinoma. Diagn Cytopathol 2011; 41:729-33. [DOI: 10.1002/dc.22807] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 10/08/2011] [Accepted: 10/30/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Stewart M. Knoepp
- Department of Pathology; University of Michigan Medical School; Ann Arbor; Michigan
| | - Kim Hookim
- Department of Pathology; University of Michigan Medical School; Ann Arbor; Michigan
| | - Jeremiah Placido
- Department of Pathology; University of Michigan Medical School; Ann Arbor; Michigan
| | - Kristina L. Fields
- Department of Pathology; University of Michigan Medical School; Ann Arbor; Michigan
| | - Michael H. Roh
- Department of Pathology; University of Michigan Medical School; Ann Arbor; Michigan
| |
Collapse
|
8
|
Colasacco C, Mount S, Leiman G. Documentation of immunocytochemistry controls in the cytopathologic literature: A meta-analysis of 100 journal articles. Diagn Cytopathol 2011; 39:245-50. [DOI: 10.1002/dc.21370] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
9
|
Chakraborty S, Bonthu N, Swanson BJ, Batra SK. Role of mucins in the skin during benign and malignant conditions. Cancer Lett 2010; 301:127-41. [PMID: 21146919 DOI: 10.1016/j.canlet.2010.11.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 10/31/2010] [Accepted: 11/07/2010] [Indexed: 12/12/2022]
Abstract
Skin-related diseases comprise a major health challenge to the practicing physician, and constitute a significant psychological, social and financial burden to the society. Further, skin cancer, especially non-melanoma skin cancer is currently the leading type of malignancy in the Western world. Given the huge burden of skin diseases, there is growing emphasis on understanding their pathophysiology, and towards their early detection. Mucins are high-molecular weight O- and N-linked glycoproteins that have emerged in recent years as important molecules in maintaining health and in promoting or protecting against inflammation and cancer. They have also begun to emerge as highly specific diagnostic and prognostic markers and novel therapeutic targets in several malignant disorders. However, their role in cutaneous pathologies has remained largely obscured. The present review provides the expression patterns and proposed role of mucins in the healthy skin and various benign and malignant skin diseases. The review has immense clinical significance as the availability of highly specific reagents including monoclonal antibodies against mucins makes them extremely attractive targets for specific diagnosis and/or immunotherapy of benign and malignant cutaneous diseases.
Collapse
Affiliation(s)
- Subhankar Chakraborty
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, USA
| | | | | | | |
Collapse
|
10
|
McCardle TW, Sondak VK, Zager J, Messina JL. Merkel cell carcinoma: pathologic findings and prognostic factors. Curr Probl Cancer 2010; 34:47-64. [PMID: 20371074 DOI: 10.1016/j.currproblcancer.2010.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
11
|
Lymph nodes. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
12
|
Güler-Nizam E, Leiter U, Metzler G, Breuninger H, Garbe C, Eigentler TK. Clinical course and prognostic factors of Merkel cell carcinoma of the skin. Br J Dermatol 2009; 161:90-4. [PMID: 19438439 DOI: 10.1111/j.1365-2133.2009.09155.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy of the skin first described by Toker as 'trabecular carcinoma of the skin' in 1972. To date, the origin of the tumour cells still remains unclear. OBJECTIVES The present study analyses prognostic factors of MCC. PATIENTS AND METHODS The medical records of 57 patients with MCC treated between 1988 and 2006 at the Department of Dermatology in Tübingen were reviewed. RESULTS We identified 26 (45.6%) male and 31 (54.4%) female patients with MCC; the age at diagnosis ranged from 26 to 97 years (median 71 years). Primary tumours were located mainly on the head and neck areas (27 cases, 47.4%) and upper extremities (14 cases, 24.6%); 11 tumours were found on the lower extremities (19.3%) and four lesions on the chest (7%); one patient had an unknown primary location. Forty-five (78.9%) patients were diagnosed at stage I of the disease, 11 (19.3%) at stage II, and one patient (1.8%) at stage III at initial presentation. Stage of the disease and age at initial presentation were statistically significant with regard to overall (P < 0.0001; P = 0.0327) and tumour-specific survival (P < 0.0001; P = 0.0156). Use of the Cox regression model revealed initial stage of the disease as the only significant factor in the multivariate analysis. Radiotherapy applied promptly after excision of the primary tumour extended the time to progression significantly (P = 0.0376) but did not prolong overall or tumour-specific survival. Other parameters such as sex, site of tumour, sentinel node biopsy, excision margins, skin and noncutaneous malignancies were found to be not significant. CONCLUSIONS Currently, early recognition of the disease seems to be the only method of ensuring overall survival. However, evidence-based treatment modalities are still urgently needed.
Collapse
Affiliation(s)
- E Güler-Nizam
- Department of Dermatology, University-Hospital Tübingen, Eberhard-Karls-University, Liebermeisterstrasse 25, Tübingen D-72076, Germany
| | | | | | | | | | | |
Collapse
|
13
|
Daugherty HK, Rumboldt T, Hoda RS. Contralateral metastasis of a cutaneous Merkel cell carcinoma: Diagnosis by fine needle aspiration cytology. Diagn Cytopathol 2005; 33:450-1. [PMID: 16299738 DOI: 10.1002/dc.20350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
14
|
|
15
|
Farinola MA, Weir EG, Ali SZ. CD56 expression of neuroendocrine neoplasms on immunophenotyping by flow cytometry: a novel diagnostic approach to fine-needle aspiration biopsy. Cancer 2003; 99:240-6. [PMID: 12925986 DOI: 10.1002/cncr.11458] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND CD56 antigen or NCAM (neural cell adhesion molecule) has an established role in the diagnosis of non-Hodgkin lymphoma (NHL)-natural killer cell type and other hematologic malignancies. Therefore, it is included routinely in the panel of antibodies for flow cytometric (FC) analysis of suspected lymphomatous tissue specimens obtained from fine-needle aspiration biopsy (FNAB). The authors evaluated the role of CD56 expression on FC of neuroendocrine (NE) tumors. An initial diagnosis of NHL was suspected based on an on-site FNAB evaluation. METHODS Ten FNABs were identified from the cytopathology files at The Johns Hopkins Hospital, Baltimore, MD (2000-2001). Flow cytometric analysis was negative for NHL but revealed a CD56-positive nonlymphoid cell population. An FNAB evaluation was performed on air-dried Diff-Quik-stained smears and FC analysis used a fixed panel of 12 antibodies (B-cell markers, T-cell markers, CD33, CD56, and CD71). Immunoperoxidase staining (IPOX) was performed on the cell block sections from four of the tissue specimens using epithelial and NE markers, CD56, desmin, and O13 antibodies. Sites of FNAB included the lung (five cases), liver (one case), lymph node (three cases), and peritoneum (one case). Only one patient had a history of cancer at the time of FNAB. RESULTS All cytologic diagnoses were confirmed by histopathologic follow-up on resection or biopsy or both. Diagnoses included small cell carcinoma (eight cases), Merkel cell carcinoma (one case), and primitive neuroectodermal tumor/Ewing sarcoma (one case). All tissue specimens that underwent IPOX stained strongly with NE markers, with one tissue section staining only with O13. CONCLUSIONS CD56 expression by FC in the presence of negative immunostaining with lymphoid markers represented a unique yet highly specific method for the diagnosis of NE tumors by FNAB. This procedure eliminated the need for further IPOX studies on the already limited cytologic sample and provided a timely and accurate diagnosis.
Collapse
Affiliation(s)
- Maryam A Farinola
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | | | | |
Collapse
|
16
|
Affiliation(s)
- Wolfram Goessling
- Department of Adult Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | | | | |
Collapse
|
17
|
Lemos MM, Kindblom LG, Meis-Kindblom JM, Ryd W, Willén H. Fine-needle aspiration features of pilomatrixoma. Cancer 2001; 93:252-6. [PMID: 11507698 DOI: 10.1002/cncr.9038] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pilomatrixoma (PMX) is a benign skin neoplasm of hair matrix origin. The fine-needle aspiration (FNA) features of PMX frequently lead to a misdiagnosis of carcinoma. METHODS Nine cases of PMX in which a preoperative FNA was performed were reviewed. The cytologic features were compared with the histologic appearance of corresponding surgical specimens as well as with cytologic features of tumors that arose in the differential diagnosis. RESULTS Unequivocal benign diagnoses were rendered in three cases; the correct preoperative diagnosis of PMX was rendered in two of these cases and considered in an additional case. In four additional cases, carcinoma was diagnosed or could not be excluded. A noncommittal diagnosis of epithelial tumor, most likely of skin adnexal origin, was rendered in an additional single case. Retrospective review of the FNA smears in all nine instances disclosed cytologic features that corresponded well with the histologic components of PMX. Diagnostic cytologic features included cellular aspirates; clusters of small, primitive-appearing basaloid epithelial cells; a high nuclear-cytoplasmic ratio; evenly dispersed chromatin; prominent nucleoli; pink, fibrillary material enveloping clusters of basaloid cells; multinucleated giant cells; and sheets of ghost cells. CONCLUSIONS The FNA cytologic diagnosis of PMX may be extremely difficult; its distinction from various primary cutaneous carcinomas is most problematic. Recognition of a unique constellation of cytologic features in FNA smears in the appropriate clinical context is most helpful in making this distinction.
Collapse
Affiliation(s)
- M M Lemos
- Department of Pathology, Gothenburg University Musculoskeletal Tumor Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | | | | |
Collapse
|
18
|
Henke AC, Cooley ML, Hughes JH, Timmerman TG. Fine-needle aspiration cytology of small-cell carcinoma of the parotid. Diagn Cytopathol 2001; 25:126-9. [PMID: 11477719 DOI: 10.1002/dc.2019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Small-cell carcinomas arise uncommonly in extrapulmonary sites and are rare primary neoplasms in the salivary glands. We report on the aspiration cytology and immunohistochemical findings of a small-cell carcinoma of the parotid gland in an 81-yr-old man.
Collapse
Affiliation(s)
- A C Henke
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | | | | | | |
Collapse
|
19
|
Solomon RK, Lundeen SJ, Hamlar DD, Pambuccian SE. Fine-needle aspiration diagnosis of unusual cutaneous neoplasms of the scalp in HIV-infected patients: a report of two cases and review of the literature. Diagn Cytopathol 2001; 24:186-92. [PMID: 11241902 DOI: 10.1002/1097-0339(200103)24:3<186::aid-dc1038>3.0.co;2-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We report on two unusual, non-AIDS-defining scalp neoplasms, Merkel-cell carcinoma (MCC) and malignant melanoma, in 2 men with acquired immunodeficiency syndrome (AIDS). In the first patient, metastatic MCC was initially diagnosed by fine-needle aspiration (FNA) of a posterior cervical lymph node, based on the cytomorphology and the characteristic immunohistochemical and ultrastructural features. No skin lesion was initially apparent, but a 0.3-mm scalp primary was found during the ensuing neck dissection. In the second patient, recurrent and metastatic malignant melanoma from a Breslow 1.3-mm scalp primary was diagnosed by FNA. Both patients developed generalized disease in a relatively short time, despite their small primaries. These cases illustrate the occurrence of Merkel-cell carcinoma and melanoma in AIDS patients, and stress the need to consider these unusual cutaneous neoplasms when evaluating lymph node FNA samples from HIV-positive patients, especially since both may present as metastases from clinically occult primaries.
Collapse
Affiliation(s)
- R K Solomon
- Department of Laboratory Medicine and Pathology, Fairview University Medical Center, University of Minnesota Medical School, Minneapolis 55455, USA
| | | | | | | |
Collapse
|
20
|
Sadeghi S, Pitman MB, Weir MM. Cytologic features of metastatic sebaceous carcinoma: report of two cases with comparison to three cases of basal cell carcinoma. Diagn Cytopathol 1999; 21:340-5. [PMID: 10527482 DOI: 10.1002/(sici)1097-0339(199911)21:5<340::aid-dc9>3.0.co;2-c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The cytologic findings of two cases of metastatic sebaceous carcinoma are described and compared to three cases of locally recurrent basal cell carcinoma. Morphological findings for sebaceous carcinoma in fine-needle aspiration biopsy (FNAB) smears included cellular, loosely cohesive cell clusters with central necrosis, squamous pearl formation, and adjacent keratin debris. The tumor cells had moderate amounts of vacuolated cytoplasm, round to oval vesicular nuclei with clumped chromatin, nucleoli, some nuclear overlap, and numerous mitotic figures. An interesting finding was the presence of numerous multinucleated giant cells, probably responding to extravasated lipid or keratin material. In contrast, the FNAB smears of basal cell carcinoma typically were less cellular, with more tightly cohesive and smaller clusters of uniform hyperchromatic basaloid cells with high nuclear to cytoplasmic ratios, and a narrow rim of cytoplasm without vacuolization. The morphologic features of sebaceous carcinoma in FNAB smears appear to be distinct from those of basal cell carcinoma. FNAB can be a useful preoperative diagnostic technique to distinguish these two cutaneous malignancies.
Collapse
Affiliation(s)
- S Sadeghi
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
| | | | | |
Collapse
|
21
|
|