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Case 58 - Discussion

Hematopathology Case



  • Clinical History: Patient had a desmoplastic melanoma of the right forearm excised recently.

  • Microscopic Description: The large lymph node is entirely effaced by spindle neoplastic cells in bundles or fascicles with focal myxoid degeneration. Most of the tumor cells are intermediate in size with moderate to abundant pale cytoplasm and round, oval or spindle nuclei. The chromatin is rather evenly disposed without visible nucleoli. Scattered epithelioid neoplastic cells are present. Frequent mitotic figures are present. By immunostains, the scattered epithelioid cells but not the spindle cells are positive for MITF, S100, MUC-1, and HMB45. Both the epithelioid and spindle tumor cells are positive for vimentin but negative for CK AE1:3 and LCA.

  • Final Diagnosis: metastatic desmoplastic melanoma