Van Ells Becky L, Madory James E, Hoda Rana S
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Cytojournal. 2007 Sep 19;4:18. doi: 10.1186/1742-6413-4-18.
Desmoplastic melanoma is a variant of malignant melanoma that can range in appearance from sarcomatoid to scar-like. Cytomorphology of desmoplastic melanoma has been previously described on conventional smears; however, to our knowledge, detailed cytomorphology on ThinPrep has so far not been described. Herein, we describe the cytomorphology of two cases of desmoplastic melanoma on fine needle aspiration processed as ThinPrep slides and compare it to that seen on conventional smears. Pertinent immunocytochemical stains, performed on ThinPrep slides are also discussed.
The first case is a woman with a history of desmoplastic melanoma of the scalp with previous local recurrences and lymph node metastasis with a new submandibular mass. The second case is a man with a previously resected desmoplastic melanoma with his first local recurrence. Conventional smears, including air-dried Diff-Quik-stained and alcohol-fixed Papanicolaou-stained smears, demonstrated aggregates of pleomorphic spindle cells admixed with fibrous stroma and single spindle cells. In both cases, nuclei were elongated and plump with irregular nuclear contours, deep grooves, and folds. Chromatin was dark and coarse with either inconspicuous or multiple prominent nucleoli. Cytoplasm was located at the nuclear poles and was fine, wispy, and delicate. The background was clean with no evidence of necrosis or melanin pigment. Papanicolaou-stained ThinPrep slides were prepared from needle rinses and demonstrated excellent correlation of nuclear and cytoplasmic detail of single spindle cells to that seen on conventional smears with the exception of only slight decrease in nuclear size; however, nuclear and cytoplasmic detail of spindle cells embedded in stroma was markedly attenuated. Confirmatory immunostain for S-100 protein in both cases was performed on ThinPrep slides demonstrating crisp cytoplasmic staining in the spindle cells.
The cytomorphology of desmoplastic melanoma shows excellent correlation between cytomorphology of single spindle cells on conventional smears and on ThinPrep slides. The major difference noted on ThinPrep slides was attenuated nuclear and cytoplasmic detail of spindle cells embedded in fibrous stoma.
促纤维增生性黑色素瘤是恶性黑色素瘤的一种变体，其外观可从肉瘤样到瘢痕样不等。促纤维增生性黑色素瘤的细胞形态学先前已在传统涂片上有所描述；然而，据我们所知，目前尚未有关于液基薄层制片（ThinPrep）上详细细胞形态学的描述。在此，我们描述了两例经细针穿刺并制成液基薄层制片的促纤维增生性黑色素瘤的细胞形态学，并将其与传统涂片上的情况进行比较。还讨论了在液基薄层制片上进行的相关免疫细胞化学染色。
第一例为一名女性，有头皮促纤维增生性黑色素瘤病史，既往有局部复发和淋巴结转移，现出现一个新的下颌下肿块。第二例为一名男性，曾切除促纤维增生性黑色素瘤，现首次出现局部复发。传统涂片，包括空气干燥的Diff - Quik染色涂片和酒精固定的巴氏染色涂片，显示多形性梭形细胞聚集体与纤维性间质及单个梭形细胞混合存在。在这两例中，细胞核均呈细长且饱满，核轮廓不规则，有深沟和褶皱。染色质深且粗糙，核仁不明显或有多个明显核仁。细胞质位于核极，细小、呈细丝状且 delicate（此处原文可能有误，推测为delicate）。背景干净，无坏死或黑色素沉着迹象。从针冲洗液制备了巴氏染色的液基薄层制片，显示单个梭形细胞的核和细胞质细节与传统涂片所见具有良好的相关性，只是核大小略有减小；然而，包埋在间质中的梭形细胞的核和细胞质细节明显减弱。在液基薄层制片上对两例进行了S - 100蛋白的确诊免疫染色，显示梭形细胞中有清晰的细胞质染色。
促纤维增生性黑色素瘤的细胞形态学显示，传统涂片和液基薄层制片上单个梭形细胞的细胞形态学之间具有良好的相关性。在液基薄层制片上观察到的主要差异是包埋在纤维性基质中的梭形细胞的核和细胞质细节减弱。
