Amelanotic melanoma: A challenging cytological diagnosis- A case series

Abstract

Melanoma is an aggressive malignancy, and early diagnosis and treatment can reduce mortality in patients. A new or changing lesion is the most common warning sign of melanoma. In amelanotic tumors, diagnosis may be delayed. Amelanotic melanoma is a form of melanoma in which malignant cells have little or no pigment. Amelanotic melanoma is classically described as skin coloured but a subset of these tumors are red, pink or erythematous. Typical early lesions present as asymmetrical macular lesions. FNAC may show varied cytomorphology ranging from epithelioid to spindled to plasmacytoid pleomorphic cells with marked anisonucleosis and eosinophilic to basophilic cytoplasm with intranuclear pseudoinclusions and cytoplasmic vacoulations admixed with bi- and multinucleate giant cells. We present a case series of varied presentation of amelanotic melanoma with its cytomorphological features.