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Endoscopic ultrasound-guided fine-needle aspiration diagnosis of merkel cell carcinoma metastatic to the pancreas

2012; Wiley; Volume: 42; Issue: 3 Linguagem: Inglês

10.1002/dc.22884

8755-1039

Jane Bernstein, Adebowale Adeniran, Guoping Cai, Constantine G.A. Theoharis, Berrin Ustun, Danita Beckman, Harry R. Aslanian, Malini Harigopal,

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Merkel cell carcinoma (MCC) is a rare and highly aggressive primary neuroendocrine carcinoma of the skin with a high propensity for local, regional, and distant spread. Distant metastasis of MCC to the pancreas is uncommonly seen and may impose a diagnostic challenge cytologically. Here we report a case of MCC with pancreatic metastasis, which was diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA). The aspirates revealed both single and clustered epithelial cells with scant cytoplasm and round nuclei with stippled chromatin and inconspicuous nucleoli. Immunocytochemically, the tumor cells were positive for CK20, synaptophysin, CD56, and CD117. The neoplastic cells were also identified by flow cytometry as non‐hematopoietic cells which were positive for CD56 and negative for CD45. To our knowledge, this is only the second case report of MCC metastatic to the pancreas diagnosed by EUS‐FNA. There have been several reports of MCC metastatic to the pancreas diagnosed only at the time of surgical resection. However, a preoperative diagnosis allows for appropriate management while sparing a patient the morbidity of unnecessary procedures. Diagn. Cytopathol. 2014;247–252. © 2012 Wiley Periodicals, Inc.