melanoma from a child, followup specimens

MALIGNANT MELANOMA FROM A CHILD, FOLLOW-UP SPECIMENS

Following the diagnosis of malignant melanoma, the first of two skin excisions was performed. No tumor was found in the second one. Inguinal lymph nodes were removed.

The first excisional skin specimen contained an expansile tumor mass that was deeper than the original biopsy. This would qualify either as an intradermal micrometastasis or as a rapid recurrence of the original tumor. Lymph node involvement was demonstrated in some of the H&E stained sections, and a few small clusters of tumor cells were found only in the S-100 immunoperoxidase preparations.

Scan power view of the initial excisional skin specimen demonstrating a deep tumor nodule (TN). Note the superficial reaction to the biopsy.

Low power view of and edge of the tumor nodule. Abortive nesting patterns are being formed by atypical cells.

High power view of above.

Low power view of a lymph node. Tumor (TC) is visible within the parenchyma of the node. These are not in the capsule or subcapsular space where most 'nodal nevi' are incidentally found.

High power view of some of the tumor cells.

Another high power view. These cells are more pleomorphic and atypical than incidental 'nodal nevus' cells.

S-100 immunoperoxidase preparation showing a few small nests and single cells not noticed in the H&E stained sections. There were no pigmented macrophages in the H&E stained sections.

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	Low power view of and edge of the tumor nodule. Abortive nesting patterns are being formed by atypical cells.
	High power view of above.
	Low power view of a lymph node. Tumor (TC) is visible within the parenchyma of the node. These are not in the capsule or subcapsular space where most 'nodal nevi' are incidentally found.
	High power view of some of the tumor cells.
	Another high power view. These cells are more pleomorphic and atypical than incidental 'nodal nevus' cells.
	S-100 immunoperoxidase preparation showing a few small nests and single cells not noticed in the H&E stained sections. There were no pigmented macrophages in the H&E stained sections.