TY - JOUR
T1 - Endoscopic ultrasound-guided fine-needle aspiration diagnosis of merkel cell carcinoma metastatic to the pancreas
AU - Bernstein, Jane
AU - Adeniran, Adebowale J.
AU - Cai, Guoping
AU - Theoharis, Constantine G.A.
AU - Ustun, Berrin
AU - Beckman, Danita
AU - Aslanian, Harry R.
AU - Harigopal, Malini
PY - 2014/3
Y1 - 2014/3
N2 - Merkel cell carcinoma (MCC) is a rare and highly aggressive primary neuroendocrine carcinoma of the skin with a high propensity for local, regional, and distant spread. Distant metastasis of MCC to the pancreas is uncommonly seen and may impose a diagnostic challenge cytologically. Here we report a case of MCC with pancreatic metastasis, which was diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aspirates revealed both single and clustered epithelial cells with scant cytoplasm and round nuclei with stippled chromatin and inconspicuous nucleoli. Immunocytochemically, the tumor cells were positive for CK20, synaptophysin, CD56, and CD117. The neoplastic cells were also identified by flow cytometry as non-hematopoietic cells which were positive for CD56 and negative for CD45. To our knowledge, this is only the second case report of MCC metastatic to the pancreas diagnosed by EUS-FNA. There have been several reports of MCC metastatic to the pancreas diagnosed only at the time of surgical resection. However, a preoperative diagnosis allows for appropriate management while sparing a patient the morbidity of unnecessary procedures.
AB - Merkel cell carcinoma (MCC) is a rare and highly aggressive primary neuroendocrine carcinoma of the skin with a high propensity for local, regional, and distant spread. Distant metastasis of MCC to the pancreas is uncommonly seen and may impose a diagnostic challenge cytologically. Here we report a case of MCC with pancreatic metastasis, which was diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aspirates revealed both single and clustered epithelial cells with scant cytoplasm and round nuclei with stippled chromatin and inconspicuous nucleoli. Immunocytochemically, the tumor cells were positive for CK20, synaptophysin, CD56, and CD117. The neoplastic cells were also identified by flow cytometry as non-hematopoietic cells which were positive for CD56 and negative for CD45. To our knowledge, this is only the second case report of MCC metastatic to the pancreas diagnosed by EUS-FNA. There have been several reports of MCC metastatic to the pancreas diagnosed only at the time of surgical resection. However, a preoperative diagnosis allows for appropriate management while sparing a patient the morbidity of unnecessary procedures.
KW - Merkel cell carcinoma
KW - cytology
KW - fine-needle aspiration
KW - pancreas
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U2 - 10.1002/dc.22884
DO - 10.1002/dc.22884
M3 - Article
C2 - 22730170
AN - SCOPUS:84894229537
SN - 8755-1039
VL - 42
SP - 247
EP - 252
JO - Diagnostic Cytopathology
JF - Diagnostic Cytopathology
IS - 3
ER -