腹水送检 转移性黑素瘤讨论病例【中美加非妇科细胞学交流群病例131】

小王

冷继红
男性，71岁。左侧鼻腔恶性黑色素瘤术后2年3个月，腹水送检。CT报告结果：









细胞块





CR



VImentin



MART-1



HMB45



Ki67



荆欣
@冷继红一吉林省肿瘤医院 Malignant cells, morphologically consistent with melanoma. Do you have Meilan A or SOX10? These two markers are more sensitive than HMB45.

冷继红
免疫细胞化学结果：CR-、CK-、Vimentin+、MART-1部分+、HMB45部分+、S-100-、Ki-67+1%、CD45-。


荆欣
Morphological features, along with the immoprofile supports metastatic melanoma@冷继红一吉林省肿瘤医院

钱晓华
Melanoma cells are cytoplasmic for WT-1, very distinct in fluids.



赵澄泉
@钱晓华 BWH good to know WT1 for MM. 正常黑色素细胞也浆阳吗？

钱晓华
@赵澄泉UPMC think so. But not 100% sure. Will get back to you later.

荆欣
@赵澄泉UPMC We see many Melanoma specimens at UMich. One previous specimen showed cells with vacuolated cytoplasm, positive for epithelial markers, mimicking adenocarcinoma.

钱晓华
@冷继红一吉林省肿瘤医院 hope you have WT-1.

荆欣
The malignant cells in the current specimen show classic features of melanoma- single cell pattern, plasmacytoid cells, bi-or multi- nucleations, coarse chromatin, cherry red macronucleoli, etc.@赵澄泉UPMC @钱晓华 BWH @冷继红一吉林省肿瘤医院 

冷继红
反馈传病例加做的WT-1结果，阴性。





钱晓华
@冷继红一吉林省肿瘤医院 谢谢返馈。但为什么正常间皮细胞也是阴性？

冷继红
免疫细胞化学结果：CR-、CK-、Vimentin+、MART-1部分+、HMB45部分+、S-100-、Ki-67+1%、CD45-。
CR



荆欣
@冷继红一吉林省肿瘤医院 Are you taking about the sample from the patient with history of melanoma? I don’t feel that adding more immunostains will help you.

冷继红
@荆欣@UMich-AA  上传的病例为，男性，71岁。左侧鼻腔恶性黑色素瘤术后2年3个月，腹水送检。



CT结果

荆欣
@冷继红一吉林省肿瘤医院 The morphology and immunoprofile are compatible with melanoma.

冷继红
@荆欣@UMich-AA  谢谢老师！