Cytologically Yours: CoW: 20140106

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Contents

Clinical Summary

64 year old male who presented to the ED with shortness of breath.

Past Medical History

  • Hypertension
  • Dyslipidemia
  • Recent diagnosis of metastatic melanoma of unknown primary

Past Surgical History

  • Metastatic melanoma of unknown primary diagnosed in an enlarged axillary mass that was removed several months previously.

Radiology

  • CXR and CT showed multiple pulmonary nodules and bilateral pleural effusions.

Clinical Plan

Thoracentesis

Pathology

Cytology

Click here to toggle the diagnosis and discussion.

Final Diagnosis

Cytology

  • Metastatic melanoma.


Cell Block

Discussion

Melanoma is "the great mimicer", it's cytomorphology can be very variable. Prominent nucleoli and pigment are some of the features that can help guide a pathologist to the diagnosis. The use of the immunohistochemical markers MART-1, S100, MITF,and MelanA are useful for the diagnosis of melanoma.