Slide 97.Malignant melanoma, Eye

A. Brief Descriptions

  1. Arising from pigmented neuroepithelia or uveal melanocytes.

  2. Most common in posterior choroid in eye. 

B. Gross Findings

  1. Apple & Blodi classification

    • Obvious and unquestionable nevi and melanocytoma

    • Phase A tumor:

      • Relatively small, not extended or metastatic beyond eye

      • Most cells classified toward benign end and stationary or slow growing

    • Phase B tumor:

      • Large, extensive and rapid growth with malignant bizarre cells

  2. Callender classification

    • Spindle A and spindle B cell groups

      • Slender, elongated, spindle shape, cohesive cells

      • With poorly visualized cell border

      • Slender, elongated, spindle shaped nuclei

      • Spindle A cells : devoid of nucleolus

      • Spindle B cells : larger, with prominent nucleoli

    •  Fascicular: cells in parallel rows, bundles about dilated vessels, with palisading nuclei

    • Mixed spindle and epithelioid cells

    • Epithelioid cells:

      • Larger cells variation in size and shape

      • Well-demarcated, poorly cohesive

      • Abundant cytoplasm, hyperchromatic nucleus with prominent nucleoli

      • Frequent mitosis

      • Multinucleated tumor giant cells

C. Micro Findings

  1. Tumor grows into vitrous cavity with elevated retinal layer with dark-brown melanin pigments.

  2. Epithelioid cells with large cell size, abundant cytoplasm, hyperchromatic nuclei and prominent nucleoli.

  3. Layer of spindle cells, some with prominent nucleoli. 

D. Others

  1. Arising from pigmented neuroepithelia or uveal melanocyte

  2. Most common in posterior choroid in eye

E. Reference

  1.  Robbins pathologic basis of disease. Ch31. p.1366-1367.






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