Fine-needle aspiration diagnosis of unusual cutaneous neoplasms of the scalp in HIV-infected patients: a report of two cases and review of the literature.
We report on two unusual, non-AIDS-defining scalp neoplasms, Merkel-cell carcinoma (MCC) and malignant melanoma, in 2 men with acquired immunodeficiency syndrome (AIDS). In the first patient, metastatic MCC was initially diagnosed by fine-needle aspiration (FNA) of a posterior cervical lymph node, based on the cytomorphology and the characteristic immunohistochemical and ultrastructural features. No skin lesion was initially apparent, but a 0.3-mm scalp primary was found during the ensuing neck dissection. In the second patient, recurrent and metastatic malignant melanoma from a Breslow 1.3-mm scalp primary was diagnosed by FNA. Both patients developed generalized disease in a relatively short time, despite their small primaries. These cases illustrate the occurrence of Merkel-cell carcinoma and melanoma in AIDS patients, and stress the need to consider these unusual cutaneous neoplasms when evaluating lymph node FNA samples from HIV-positive patients, especially since both may present as metastases from clinically occult primaries.
Department of Laboratory Medicine and Pathology, Fairview University Medical Center, University of Minnesota Medical School, Minneapolis 55455, USA.
R K
RK
Solomon
S J
SJ
Lundeen
D D
DD
Hamlar
S E
SE
Pambuccian
D001707:Biopsy, Needle; D015266:Carcinoma, Merkel Cell / Q000150:complications / Q000175:diagnosis; D015658:HIV Infections / Q000150:complications / Q000473:pathology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D012535:Scalp; D012878:Skin Neoplasms / Q000150:complications / Q000175:diagnosis*