Bronchial Malignant Melanoma

Bronchial Malignant Melanoma
Key Facts
Clinical Issues
  • Incidence
    • Approximately 0.01% of all lung neoplasms
    • More common in adults in 6th decade of life
  • Symptoms
    • Cough
    • Dyspnea
    • Chest pain hemoptysis
    • Fever
  • Endoscopic findings
    • Possible pigmented lesion
Microscopic Pathology
  • Nested pattern
  • Spindle cell pattern
  • Pigmented lesion
Top Differential Diagnoses
  • Carcinoma
    • Will show negative staining for S100 protein, HMB-45, &/or mart-1
  • Neuroendocrine carcinoma
    • Melanomas are generally negative for neuroendocrine markers, i.e., chromogranin-A and synaptophysin
  • Neurogenic sarcoma
    • S100 may show positive staining in both tumors
    • Negative for HMB-45 and mart-1
  • Metastatic melanoma
    • Clinical history is most important and reliable way to determine primary site
    • Ocular evaluation is highly important
Primary bronchial melanoma involving full thickness of the bronchial epithelium. Note the presence of residual endobronchial glandular structures image as well as bronchial cartilage image.
High-power view of a bronchial malignant melanoma shows prominent nuclear atypia and mitotic activity. Cellular pleomorphism is a common feature of bronchial melanoma
TERMINOLOGY
Synonyms
  • Pulmonary malignant melanoma
Definitions
  • Malignant neoplasm of possible neural crest derivation
ETIOLOGY/PATHOGENESIS
Etiology
  • No specific etiology for these tumors when they occur in the lung
CLINICAL ISSUES
Epidemiology
  • Incidence
    • Estimated that primary pulmonary melanomas represent approximately 0.01% of all lung neoplasms
  • Age
    • More common in adults in 6th decade of life
  • Gender
    • No gender predilection
Presentation
  • Cough
  • Shortness of breath
  • Chest pain
  • Hemoptysis
  • Fever
Endoscopic Findings
  • Possible pigmented lesion
Treatment
  • Surgical approaches
    • Lobectomy or pneumonectomy
  • Adjuvant therapy
    • Probable chemotherapy
Prognosis
  • Variable
    • Death within 30 months after initial diagnosis
    • Possible survival at 5 years of 40%
MACROSCOPIC FEATURES
General Features
  • Well-defined tumor mass
  • Pigment
  • Homogeneous surface
  • Areas of necrosis &/or hemorrhage may be seen
  • Polypoid bronchial mass in some cases
MICROSCOPIC PATHOLOGY
Histologic Features
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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Bronchial Malignant Melanoma

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