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Abstract

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Article in Japanese

Case Report

A case of amelanotic malignant melanoma of the mediastinal lymph node from an unknown primary

Takumi Kinjoa  Takehiro Hashimotoa  Ryosuke Machidab  Takashige Miyaharab  Takayuki Shiinac  Kunihiko Shingud 

aDepartment of General Medicine, Nagano Matsushiro General Hospital
bDepartment of Respiratory Medicine, Nagano Matsushiro General Hospital
cDepartment of Thoracic Surgery, Shinshu University School of Medicine
dDepartment of Laboratory Medicine, Shinshu University School of Medicine

ABSTRACT

A 58-year-old woman presented with an abnormal shadow on the left hilum of chest computed tomography (CP) on her first annual check. A diagnosis by a transbronchial aspiration biopsy led to the suspicion that it was a malignant mesothelioma. This seemed possible because the tumor cells with nuclear pleomorphism were positive for the immunostain of calretinin and vimentin. The PET-CT scan showed the acceleration of glucose uptake only in the left hilar lesion. We diagnosed her primary malignant hilar lung tumor of clinical staging T3N1M0, Stage IIIA. She received a left pneumonectomy. The resected lesion was the left hilar lymph node. There were no melanotic granules contained in the malignant cells, those were immunohistochemically positive for Melan-A and S-100, but negative for HMB-45. Although systemic examinations were thoroughly performed, we could detect no primary lesion. Consequently the final diagnosis was lymph node metastasis of an amelanotic malignant melanoma from an unknown primary.

KEYWORDS

Amelanotic malignant melanoma  Positron emission tomography-computed tomography  Transbronchial aspiration biopsy  Immunohistochemistry  Lymph node metastasis 

Received 18 Sep 2012 / Accepted 10 Dec 2012

AJRS, 2(3): 305-310, 2013

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