The utility of fine needle aspiration in the diagnosis of melanoma metastatic to lymph nodes

Basler, Geoffrey C.; Fader, Darrell J.; Yahanda, Alan M.; Sondak, Vernon K.; Johnson, Timothy M.

doi:10.1016/s0190-9622(97)80216-2

Cited by 58 publications

(57 citation statements)

References 25 publications

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“…The location of the sentinel node in the groin is determined by using the camera and by visualisation of blue dye in the node (Fig-2). When this combined approach is used, 98% of sentinel nodes are successfully identified in our department which corresponds favourably with the published literature (6)(7)(8)(9)(10)(11) . Sentinel lymph node biopsy has been studied most extensively in the context of malignant melanoma (12) .…”

Section: Sentinel Lymph Node Biopsy (Fig-2)supporting

confidence: 88%

Surgical Management of M etastatic groin lymphadenopathyRetrospective study of 50 Cases in Regional Cancer Center

Dasappa¹

2018

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Section: Sentinel Lymph Node Biopsy (Fig-2)supporting

confidence: 88%

Surgical Management of M etastatic groin lymphadenopathyRetrospective study of 50 Cases in Regional Cancer Center

Dasappa¹

2018

jmscr

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“…It first has to be performed by well-trained experts and, second, the risk of producing low quality smears with low cell numbers is increased in the case of smaller lesions. Until now, most studies focusing on the FNAC technique reported exceedingly high rates for sensitivity and specificity (Perry et al, 1988;Fornage and Lorigan, 1989;Schoengen et al, 1993;Basler et al, 1997), yet were based on results obtained from aspirates of larger tumours and, originated from clinical centres where experts investigate large numbers of FNAC samples each year. One aim of this study was to find out whether the FNA-PCR method could reproduce these results.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, in case of a negative RT-PCR from an ultrasonographically suspicious lesion, control by B-scan examination and FNA-PCR in short intervals would allow to recognize a slow growing metastasis still in time. Therefore, FNA-PCR together with B-scan examination can properly fit into already published diagnostic algorithms of unclear lesions (Basler et al, 1997), and may help to make early diagnosis of metastatic disease less invasive and less related to severe morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…If subcutaneous (s.c.) lesions or suspicious lymph nodes are detected, fine-needle aspirates are obtained for cytological examination (FNAC) (Perry et al, 1988;Fornage and Lorigan, 1989;Schoengen et al, 1993;Basler et al, 1997). Routine use of FNAC allows definite diagnosis of melanoma metastases within less than 1 day, it speeds up the organization of necessary staging procedures, spares the patient from diagnostic surgery and therefore is also a cost-decreasing approach.…”

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confidence: 99%

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Detection of regional melanoma metastases by ultrasound B-scan, cytology or tyrosinase RT-PCR of fine-needle aspirates

et al. 1999

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Summary Physical examination and ultrasound B-scan screening are important follow-up procedures in melanoma patients with regional disease. However, they do not allow definite diagnosis of suspicious lesions. Fine-needle aspiration cytology (FNAC) enhances the diagnostic accuracy in such patients but, unfortunately, reaches its technical limits, particularly when very small or necrotic lesions are examined. We therefore tested whether tyrosinase reverse transcription polymerase chain reaction (RT-PCR) of fine-needle aspirates (FNA-PCR) could help to increase diagnostic sensitivity. With clinical follow-up in 69 melanoma patients 81 regional lymph nodes were detected by ultrasound Bscan examination, nine of whom appeared to be palpable. Technically, FNAC was successful in all 81 lymph nodes, while FNA-PCR failed to obtain RNA at detectable levels in two lymph nodes of two patients. Of 79 lesions which have been completely evaluated by B-scan, FNAC and FNA-PCR, 44 proved to be melanoma metastases by histopathology, while the remaining 35 lesions were finally classified as non-specific lymph nodes. Of the 44 melanoma metastases 80% (n = 35) have been detected by B-scan, 90% (n = 39) by FNAC and 100% (n = 44) by FNA-PCR (P < 0.05 vs FNAC, P < 0.005 vs B-scan). In the subclass of lesions with diameters below 10 mm the sensitivities were 72% (n = 13), 78% (n = 14) and 100% (n = 18) respectively. In 35 regional lymph nodes classified as benign lesions, FNAC was always negative while FNA-PCR produced one positive result. Neither of these methods did produce false positive results in 15 control lymph nodes of non-melanoma patients. We conclude, that FNA-PCR might have superior sensitivity as compared to FNAC or ultrasound B-scan, particularly in melanoma lesions with diameters below 10 mm.Keywords: melanoma; ultrasound guided fine needle aspiration cytology (FNAC); tyrosinase reverse transcription polymerase chain reaction (RT-PCR); RT/PCR of fine needle aspiration material (FNA-PCR)

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“…237 On the other hand, cytopathology is used more frequently than biopsies for monitoring of metastasis in both human patients and animals. 15,23,39,40,197,247 Although there are few large-scale studies in veterinary literature regarding specificity and sensitivity of fine needle aspiration cytology (FNAC) for detection of metastatic neoplasia, it is in common use, particularly for melanoma, carcinomas, and mast cell tumors. 132 Morphology of melanoma in the metastatic site is frequently similar to the primary, but not always (Fig.…”

Section: Cytopathologic Variantsmentioning

confidence: 99%

A Comparative Review of Melanocytic Neoplasms

2002

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Abstract. Melanoma is a devastating disease frequently encountered within both veterinary and human medicine. Molecular changes linked with neoplastic transformation of melanocytes include mutations in genes that encode proteins intrinsic to the regulatory pathways of two tumor suppressor proteins (retinoblastoma protein and p53), proto-oncogene mutation to oncogenes, altered expression of epithelial cadherin and CD44 adhesion molecules, and upregulation of angiogenic factors and other growth factors. Histologic evaluation of the primary mass is the most common means of diagnosis, with cytology used more frequently to document metastasis. Melanoma's highly variable histologic and cytologic patterns can make diagnosis by either method problematic. Adherent epithelioid morphology, including signet ring forms, and nonadherent round and spindle forms are recognized, with pigmentation an inconsistent finding. The site of the tumor, the thickness of the primary tumor or depth of invasion, and the number of mitotic figures per high-power field or per millimeter are used histologically to predict biologic behavior, whereas site and degree of pleomorphism are typically used for cytologic preparations. Diagnosis of amelanotic melanoma can be aided by ancillary diagnostic techniques. Tumor cells are usually positive for vimentin, S100, neuron-specific enolase, and Melan-A, and negative for cytokeratin. Melan-A as a positive marker is not as sensitive as the others are but is likely more specific. Monoclonal antibodies to human melanosome-specific antigens 1 and 5 cross-react with canine antigens for a combined sensitivity rate of 83%. Mouse monoclonal antibody IBF9 specifically recognizes canine melanoma antigen and also has good sensitivity. Serologic markers, including cytokines, cell adhesion molecules, and melanoma-inhibitory activity, are being investigated as potential sentinels of melanoma. Currently, there is no single diagnostic technique capable of differentiating benign from malignant melanocytic neoplasms or predicting survival time.

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The utility of fine needle aspiration in the diagnosis of melanoma metastatic to lymph nodes

Cited by 58 publications

References 25 publications

Surgical Management of M etastatic groin lymphadenopathyRetrospective study of 50 Cases in Regional Cancer Center

Surgical Management of M etastatic groin lymphadenopathyRetrospective study of 50 Cases in Regional Cancer Center

Detection of regional melanoma metastases by ultrasound B-scan, cytology or tyrosinase RT-PCR of fine-needle aspirates

A Comparative Review of Melanocytic Neoplasms

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