Cytomorphologic features of fine-needle aspiration of metastatic and recurrent melanoma

Melanoma is an aggressive malignancy with a growing prevalence. Although early detection and excision offer a potential cure, recurrences and metastases are not uncommon. Fine-needle aspiration (FNA) can play a vital role in their detection as a relatively noninvasive, rapid, and economical alternative for tracking disease evolution. Prior clinical history and classic cytological features of melanoma (loosely cohesive smear pattern and single cells with large nuclei, prominent nucleoli, and melanin pigment) aid in cytological diagnoses. However, not all melanomas contain melanin pigment or characteristic cytologic features. We examined a large series of melanoma cases to determine the incidence of melanin pigment, the most common cell morphology, and the presence or absence of apoptosis/necrosis associated with this highly aggressive neoplasm.