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To the Editor.-Recently, Archives of Pathology & Laboratory Medicine dedicated 3 parts to updated information on melanoma and melanocytic proliferations, which is very timely and important. This letter is to discuss a few diagnostic pitfalls in melanoma about which we have recently learned.
A 38-year-old female patient with history of melanoma came to our clinic for fine-needle aspiration biopsy of a clinically suspicious left axillary lymph node. Cytology revealed somewhat small to mediumsized cohesive tumor cells that were plasmacytoid and showed neuroendocrine features. No intranuclear inclusions or melanin pigments were identified (Figure 1). Immunohistochemical study findings of the cell block were negative for S100, HMB- 45, and synaptophysin but positive for AE1/AE3 (Figure 2), chromogranin (Figure 3), and CD56. These findings were suggestive of a metastatic neuroendocrine carcinoma. Subsequent left axillary...