title: [Fine needle aspiration cytology of metastatic malignant melanoma. Improvement of results with ultrasound control].
abstract: A review of 315 fine-needle aspiration cytologies (FNAC) carried out from 1984 through 1992 in 157 patients with suspected metastatic melanoma was carried out: 176 results were confirmed by histological examination and 139 by clinical follow-up. In the first period, from 1984 through 1988, we observed 5 false-negative results out of 123 evaluable FNACs. All were caused by technical failure. In the second period, from 1988 through 1992, all fine-needle biopsies of impalpable masses were done with ultrasound guidance. Thus, we were able to avoid further false-negative results. No errors in interpretation were found. We obtained 219 true-positive and 91 true-negative results with 97.8% sensitivity, 100% specificity, 98.4% accuracy, 100% positive and 94.8% negative predictive value. In 3 cases with metastatic melanoma the cytological diagnosis only was 'malignant tumor', while in another 5 patients the cytodiagnosis of melanoma was not definitive. Immunocytology was helpful in these cases in identifying melanoma. FNAC allowed the correct diagnosis of a second malignancy in 4 cases (one papillary thyroid cancer, one Hodgkin's disease, two non-Hodgkin's lymphomas). No complications occurred. In our opinion, FNAC--for poorly defined lesions with ultrasound guidance--is a very rapid, safe and accurate method that allows reliable diagnosis of metastatic melanoma.
authors.affiliation: Medizinische Klinik, Bundeswehrkrankenhauses Ulm.
authors.forename: A
authors.initials: A
authors.lastname: Schoengen
authors.forename: T
authors.initials: T
authors.lastname: Binder
authors.forename: S
authors.initials: S
authors.lastname: Faiss
authors.forename: L
authors.initials: L
authors.lastname: Weber
authors.forename: U
authors.initials: U
authors.lastname: Zeelen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D012867:Skin / Q000000981:diagnostic imaging / Q000473:pathology; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D014159:Transducers; D014463:Ultrasonography / Q000295:instrumentation*
vernacular_title: Feinnadelaspirationszytologie beim metastasierenden malignen Melanom. Verbesserung der Ergebnisse durch Ultraschallführung.