title: Uveal melanoma: An analysis of cellular features and comparison to monosomy 3 status.
abstract: BACKGROUND
  Choroidal and ciliary body melanomas divide into two approximately equal groups. Local therapy cures one group while the other metastasizes and proves lethal. Monosomy 3 strongly associates with aggressive behavior. We analyzed a series of choroidal and ciliary body melanomas to describe the cellular features and to compare them to monosomy 3 status using the latter as a surrogate for survival.
  
  
  METHODS
  One hundred eleven specimens met the study's inclusion criteria. Following ThinPrep processing, samples were analyzed for cellular features including: cell type, nuclear grade, tumor infiltrating lymphocytes, and the presence of necrosis and melanin. FISH analysis for monosomy 3 was performed on ThinPrep slides using a threshold of 20% monosomic cells per 200 melanoma cells.
  
  
  RESULTS
  Seventy-two tumors (65%) had a mixed cell type while spindle cell type and epithelioid cell type occurred in 37 (33%) and 2 (1.8%), respectively. Seventy-five tumors (68%) had Grade 2 nuclear atypia. Monosomy 3 occurred in 57 tumors (51%). Significantly more tumors with Grade 3 nuclei had monosomy 3 (79% vs.43%, P = 0.002) and metastases (29% vs. 8%, P = 0.01). None of the 11 pure spindle cell tumors with Grade 1 nuclei metastasized or had monosomy 3.
  
  
  CONCLUSIONS
  Uveal melanoma has a relatively consistent cellular appearance, characterized by a mixed cell pattern and no more than moderate nuclear atypia. This consistent appearance aids in the cellular diagnosis but limits prognostication using cellular features. Cellular features significantly associate with monosomy 3 status only in the minority of tumors at the extremes of the morphologic spectrum.
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Fatima
authors.initials: F
authors.lastname: Hamadeh
authors.affiliation: Department of Ophthalmic Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Medina
authors.affiliation: Department of Ophthalmic Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Arun D
authors.initials: AD
authors.lastname: Singh
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Jordan P
authors.initials: JP
authors.lastname: Reynolds
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Charles V
authors.initials: CV
authors.lastname: Biscotti
mesh_terms: D002830:Choroid Neoplasms / Q000235:genetics / Q000473:pathology*; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics*; D002924:Ciliary Body / Q000473:pathology; D006801:Humans; D008545:Melanoma / Q000235:genetics / Q000473:pathology*; D009006:Monosomy; D009362:Neoplasm Metastasis
keywords: choroidal melanoma; ciliary melanoma; eye cytology; monosomy 3; uveal melanoma