1Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
2Department of Pathology, National Cancer Center, Goyang, Korea
3Center for Breast Cancer, National Cancer Center, Goyang, Korea
4Center for Specific Organs Center, National Cancer Center, Goyang, Korea
© 2019 The Korean Society of Pathologists/The Korean Society for Cytopathology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Author Contributions
Conceptualization: YK.
Data curation: JK, YK.
Formal analysis: JK, YK.
Investigation: JK, JL, SYJ, HSK, TY, YK.
Writing—original draft: JK, YK.
Writing—review & editing: JK, JL, SYJ, HSK, TY, YK.
Conflicts of Interest
The authors declare that they have no potential conflicts of interest.
NA, not applicable; IHC, immunohistochemistry; CK, cytokeratin; EMA, epithelial membrane antigen; HMB-45, human melanoma black-45; BRAF, rapidly accelerated fibrosarcoma (RAF) kinase-related oncogene homolog B; PNCMB, primary noncutaneous melanoma of the breast; PCMB, primary cutaneous melanoma of the breast.
Case No. | Study | Age (yr) | Size (cm) | Histology |
IHC |
BRAF mutations | LN status | |
---|---|---|---|---|---|---|---|---|
Positive | Negative | |||||||
1 | Bernardo et al. [16] | 76 | 2.5 | Meshwork of spindle cells with heavy granular pigmentation | NA | NA | NA | No |
2 | Roy et al. [17] | 40 | 3.0 | Large pleomorphic cells with vesicular nucleus and single prominent nucleolus, moderate eosinophillic cytoplasm | S100 protein | CK | NA | No |
HMB-45 | EMA | |||||||
Vimentin | CHR | |||||||
SYN | ||||||||
SMA | ||||||||
ER, PR, HER2 | ||||||||
3 | Biswas et al. [18] | 32 | 4.0 | Abundant clear cytoplasm and large vesicular nucleus with prominent nucleolus, no pigment | S100 protein | CK | NA | No |
HMB-45 | EMA | |||||||
Vimentin | ||||||||
SMA | ||||||||
4 | He et al. [19] | 26 | 3.0 | Round or oval cells with large nuclei and abundant cytoplasm, no significant pigmentation | S100 protein | CK | NA | Yes |
HMB-45 | EMA | |||||||
Melan A | Vimentin | |||||||
SMA | ||||||||
ER, PR, HER2 | ||||||||
5 | Drueppel et al. [4] | 54 | 10.0 | Undifferentiated histology | S100 protein | HMB-45 | Negative | No |
Melan A | Desmin | |||||||
Vimentin | Actin | |||||||
CD34 | ||||||||
6 | Rassouli and Voutsadakis [5] | 50 | 1.2 | Irregular cells with abundant amelanotic cytoplasm and prominent nucleoli | S100 protein | ER | Positive | No |
HMB-45 | PR | |||||||
Melan A | p63 | |||||||
Present case | 70 | 2.1 | Polygonal epithelioid cells with eosinophilic cytoplasm and oval eccentric nucleus, no significant pigmentation | S100 protein | CK | Positive | No | |
Tyrosinase | EMA | |||||||
Vimentin | HMB-45 |
PNCMB, primary noncutaneous melanoma of the breast; IHC, immunohistochemistry; BRAF, rapidly accelerated fibrosarcoma (RAF) kinase-related oncogene homolog B; LN, lymph node; NA, not applicable; HMB-45, human melanoma black-45; CK, cytokeratin; EMA, epithelial membrane antigen; CHR, chromogranin; SMA, smooth muscle actin; ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor 2.
Case 1 | Case 2 | |
---|---|---|
Age (yr) | 70 | 30 |
Sex | Female | Female |
Location of tumor | Right breast parenchyme | Left breast skin |
Upper inner quadrant | ||
Key histologic features | Atypical epithelioid cells | Atypical melanocytes |
No pigmentation (amelanotic) | Heavy pigmentation | |
Size of tumor (cm) | 2.1 | 4.5 |
Depth of invasion (mm) | NA | 2 |
Sentinel lymph node status | Negative | Positive |
IHC | ||
CK | Negative | Negative |
EMA | Negative | NA |
Vimentin | Positive | Positive |
S100 protein | Positive | Positive |
HMB-45 | Negative | Positive |
Tyrosinase | Positive | Positive |
BRAF V600E | Positive | Positive |
Pathologic diagnosis | PNCMB | PCMB |
Case No. | Study | Age (yr) | Size (cm) | Histology | IHC |
BRAF mutations | LN status | |
---|---|---|---|---|---|---|---|---|
Positive | Negative | |||||||
1 | Bernardo et al. [16] | 76 | 2.5 | Meshwork of spindle cells with heavy granular pigmentation | NA | NA | NA | No |
2 | Roy et al. [17] | 40 | 3.0 | Large pleomorphic cells with vesicular nucleus and single prominent nucleolus, moderate eosinophillic cytoplasm | S100 protein | CK | NA | No |
HMB-45 | EMA | |||||||
Vimentin | CHR | |||||||
SYN | ||||||||
SMA | ||||||||
ER, PR, HER2 | ||||||||
3 | Biswas et al. [18] | 32 | 4.0 | Abundant clear cytoplasm and large vesicular nucleus with prominent nucleolus, no pigment | S100 protein | CK | NA | No |
HMB-45 | EMA | |||||||
Vimentin | ||||||||
SMA | ||||||||
4 | He et al. [19] | 26 | 3.0 | Round or oval cells with large nuclei and abundant cytoplasm, no significant pigmentation | S100 protein | CK | NA | Yes |
HMB-45 | EMA | |||||||
Melan A | Vimentin | |||||||
SMA | ||||||||
ER, PR, HER2 | ||||||||
5 | Drueppel et al. [4] | 54 | 10.0 | Undifferentiated histology | S100 protein | HMB-45 | Negative | No |
Melan A | Desmin | |||||||
Vimentin | Actin | |||||||
CD34 | ||||||||
6 | Rassouli and Voutsadakis [5] | 50 | 1.2 | Irregular cells with abundant amelanotic cytoplasm and prominent nucleoli | S100 protein | ER | Positive | No |
HMB-45 | PR | |||||||
Melan A | p63 | |||||||
Present case | 70 | 2.1 | Polygonal epithelioid cells with eosinophilic cytoplasm and oval eccentric nucleus, no significant pigmentation | S100 protein | CK | Positive | No | |
Tyrosinase | EMA | |||||||
Vimentin | HMB-45 |
NA, not applicable; IHC, immunohistochemistry; CK, cytokeratin; EMA, epithelial membrane antigen; HMB-45, human melanoma black-45; BRAF, rapidly accelerated fibrosarcoma (RAF) kinase-related oncogene homolog B; PNCMB, primary noncutaneous melanoma of the breast; PCMB, primary cutaneous melanoma of the breast.
PNCMB, primary noncutaneous melanoma of the breast; IHC, immunohistochemistry; BRAF, rapidly accelerated fibrosarcoma (RAF) kinase-related oncogene homolog B; LN, lymph node; NA, not applicable; HMB-45, human melanoma black-45; CK, cytokeratin; EMA, epithelial membrane antigen; CHR, chromogranin; SMA, smooth muscle actin; ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor 2.