An 84 year old male with history of melanoma of the scalp diagnosed two years prior, was found to have a splenic lesion on abdominal CT scan. CT scan showed a round, hypoechoic lesion in the spleen as shown by the arrow. Linear EUS examination identified a 2 cm round, hypoechoic, hypovascular and heterogeneous lesion in the spleen as shown by the arrow. Arrow in the image points towards the splenic vessels surrounding this lesion. After confirming the absence of the vessels, 25 G needle was used to perform the FNA. Cytology showed giant tumor cells with enlarged nuclei. This image shows HMB 45 immunostains of the FNA cytology. This image shows S100 immunostain. The immunophenotype was consistent with metastatic melanoma.
Manmeet Padda, MD, Yale University
Harry Aslanian, M.D., Yale University