Unexpected melanoma metastasis with E-cadherin expression in bone marrow

Finding an unexpected metastatic lesion in bone marrow biopsy (BMB) performed for a hematological indication can cause diagnostic issues. In a BMB performed in a patient with suspected acute leukemia evolved from a post-essential thrombocythemia myelofibrosis a group of atypical cells with E-cadherin expression was found. After careful morphological evaluation and further immunohistochemical staining, these cells were identified as a melanoma metastasis with E-cadherin expression. E-cadherin immunostain is performed frequently by hematopathologists to highlight erythroid cells but its expression can be found in a number of hematological and non-hematological neoplasms, including melanoma, which should be considered in the differential diagnosis of E-cadherin-expressing neoplasm.