Aims The diagnosis of metastatic cutaneous melanoma (CM) on lymph node fine needle aspiration samples may be challenging and usually requires confirmation by immunocytochemistry. However, the cytological material could be too scant to order a broad panel of markers. In this case, the pathologist is forced to choose the most advantageous antibodies. The most commonly used melanocytic markers include S100, Melan-A, HMB45 and SOX10 but their diagnostic yield on cytological samples has been poorly studied. The current work aimed to evaluate the diagnostic performance of melanocytic markers when applied to cell blocks obtained from fine needle aspiration cytology (FNAC) of lymph node metastases from CM.
Methods S100, Melan-A, HMB45 and SOX10 were tested on cell block sections of 38 lymphnode metastases from CM diagnosed by cytology. A combined score was built to evaluate each immunostaining, considering the intensity of the staining and the percentage of stained neoplastic cells.
Results S100 and SOX10 revealed a higher sensitivity (100%) than Melan-A and HMB45 for the diagnosis of metastatic CM. Furthermore, SOX10 emerged as the melanocytic marker with the best staining performance.
Conclusion SOX10 has a 100% detection rate and the most easily interpretable staining pattern compared with other melanocytic markers. Therefore, it is strongly recommended that SOX10 is included in the minimal immunocytochemical panel for the diagnostic evaluation of lymph node FNAC in patients with suspected CM metastasis.
- medical oncology
- cytological techniques
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Handling editor Dhirendra Govender.
Contributors AR: contributed to the conceptual interpretation of the data; contributed to the statistical analysis and the writing of the manuscript. FZM: contributed to the statistical analysis and the preparation of figures and tables and contributed to the conceptual interpretation of the data. GT: performed the data acquisition; contributed to the conceptual interpretation of the data. FP and DR: performed the analysis of the records in the database and provided a language revision of the manuscript; contributed to the conceptual interpretation of the data. GS: performed the analysis of the records in the database; contributed to the statistical analysis of the data and contributed to the conceptual interpretation of the data. EM and GB: contributed to the conceptual interpretation of the data; performed the analysis of the records in the database and contributed to the writing of the manuscript. GA: contributed to the conceptual interpretation of the data. RF: contributed to the conceptual interpretation of the data and editing the manuscript. IC: revised the cytological slides to confirm the cytological diagnoses; contributed to the conceptual interpretation of the data and the writing of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The present study was retrospectively conducted on archival biological samples. The cytological diagnoses and their histological confirmations had already been rendered in all cases. At the time of the FNAC procedure, a written consent, including the consent to use the diagnostic data for scientific purposes, had been obtained from each patient. The approval by institutional ethical board was collected.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article. For additional information please contact corresponding author.