The diagnostic utility of Merkel cell polyomavirus immunohistochemistry in a fine needle aspirate of metastatic Merkel cell carcinoma of unknown primary to the pancreas

Long Li, Kyle Molberg, Naga Cheedella, Joel Thibodeaux, Stacy Hinson, Elena Lucas

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Merkel cell carcinoma (MCC) is an aggressive skin tumor with a high tendency for metastases. We report a case of MCC initially presenting as axillary and pancreatic metastases. A 33-year-old HIV-positive Hispanic male presented with a history of a rapidly growing axillary mass. A needle core biopsy demonstrated an epithelioid neoplasm composed of small to medium-sized cells with high nuclear-cytoplasmic ratio, nuclear molding, and frequent mitotic figures. A subsequent PET scan revealed a 1.5 cm FDG avid mass in the pancreas. Endoscopic ultrasound-guided FNA of the pancreatic mass showed neoplastic cells with similar morphology to those of the axillary mass. The tumor cells were positive with pancytokeratin AE1/AE3, CK20, CD56, synatophysin, chromogranin, and Merkel cell polyomavirus (MCPyV). This case of MCC most likely originated from a resolved primary skin lesion drained by the involved axillary lymph node with subsequent metastases to the pancreas and distant lymph nodes.

Original languageEnglish (US)
Pages (from-to)67-71
Number of pages5
JournalDiagnostic Cytopathology
Volume46
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • immunohistochemistry
  • Merkel cell carcinoma
  • Merkel cell polyomavirus
  • pancreas
  • unknown primary

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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