Pulmonary melanoma

Definition

This entity is very rare2. The diagnosis of a primary melanoma of the lung, requires the presence of evidence of this being a primary in the form of junctional melanocytes in the bronchial epithelium3 and/or a naevus-like lesion, in the absence of a previous history of extrapulmonary melanoma.

Epidemiology

This is an extremely rare tumour.

Clinical features

The median age is 50 years3, with a male predominance3.

Macroscopic appearances

Most tumours are endobronchial2 and appear polypoidal1. Pigmentation is variable.

Histopathology

As for malignant melanoma elsewhere3.

Immunohistochemistry

As for melanomas elsewhere.

	S-100	7/73
	HMB45	7/73
	Vimentin	7/73
	cytokeratins	0/73
	Chromogranin	0/73

Ultrastructure

Melanosomes are present3.

Differential diagnosis

Metastatic melanoma
Non-small cell carcinoma3.
Carcinoid1,3: may be pigmented. Positive for cytokeratins and neuroendocrine markers, but negative for melanocytic markers.

Management

Surgical resection2.

Prognosis

Poor3.

References

0 Tumours of the Lung, Pleura, Thymus and Heart. WHO Classification of Tumours. IARC Press 2004.

1 Jennings TA, Axiotis CA, Kress Y, et al. Primary malignant melanoma of the lower respiratory tract. Report of a case and literature review. Am J Clin Pathol 1990; 94:649-55

2 Ost D, Joseph C, Sogoloff H, et al. Primary pulmonary melanoma: case report and literature review. Mayo Clin Proc 1999; 74:62-6

3 Wilson RW,Moran CA. Primary melanoma of the lung: a clinicopathologic and immunohistochemical study of eight cases. Am J Surg Pathol 1997; 21:1196-202

This page last revised 20.6.2005.