Anaplastic large cell lymphoma: A potential pitfall in the differential diagnosis of melanoma Journal Article

Authors: Pulitzer, M.; Brady, M. S.; Blochin, E.; Amin, B.; Teruya-Feldstein, J.
Article Title: Anaplastic large cell lymphoma: A potential pitfall in the differential diagnosis of melanoma
Abstract: The diagnosis of metastatic melanoma can be complicated by absent characteristic cytology, melanin, or antigen expression in a suspect tumor, putting the pathologist at risk for incorrectly diagnosing recurrent melanoma while missing a second malignancy. We report a 69-year-old man with a history of acral melanoma, metastatic to inguinal nodes, presenting with an ipsilateral thigh nodule. Histology showed a proliferation of pleomorphic cells in the dermis and subcutis, suspicious for melanoma. S100, Melan-A, and HMB-45 immunohistochemistry were negative. However, microphthalmia-associated transcription factor and CD117 labeled the neoplasm, prompting consideration of a late metastatic melanoma with loss of antigen expression. Subsequent immunolabeling for CD4, CD43, and CD30 and clonal Tcell gene rearrangements enabled the correct diagnosis of cutaneous anaplastic large cell lymphoma. This case illustrates a pitfall in evaluating tumors in patients with known metastatic melanoma, and emphasizes the need for broad-spectrum immunohistochemistry in cases that are not clear-cut.
Journal Title: Archives of Pathology & Laboratory Medicine
Volume: 137
Issue: 2
ISSN: 0003-9985
Publisher: College of American Pathologists  
Date Published: 2013-02-01
Start Page: 280
End Page: 283
Language: English
DOI: 10.5858/arpa.2011-0532-CR
PROVIDER: scopus
PUBMED: 23368872
Notes: --- - "Export Date: 1 April 2013" - "CODEN: ARPAA" - "Source: Scopus"
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MSK Authors
  1. Julie T Feldstein
    288 Feldstein
  2. Melissa P Pulitzer
    127 Pulitzer
  3. Bijal Dilip Amin
    6 Amin
  4. Mary Sue Brady
    164 Brady