Correspondence |

Pigmented Olfactory Neuroblastoma: A CD56-Positive Mimic of Melanoma

Amy Han, MD; Arni K. Kristjansson, MD; Anita C. Gilliam, MD, PhD; Gretta Jacobs, MD; Rosana Eisenberg, MD
Arch Dermatol. 2008;144(2):270-272. doi:10.1001/archdermatol.2007.52.
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We present a case of pigmented olfactory neuroblastoma of the nostril and nasal cavity that was positive for neural cell adhesion molecule (CD56) and initially diagnosed as melanoma based on patchy S-100 protein positivity. This is a possible pitfall in the microscopic diagnosis of an entity that can be confused with melanoma histologically. Usually, CD56 is thought of as a marker for natural killer cell lymphoma, but our case highlights the usefulness of CD56 in dermatopathology because mucosal biopsy specimens are occasionally sent to dermatopathology laboratories for evaluation. It also illustrates the need for an immunostaining panel on unusual pigmented tumors.

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Figure 1.

Initial biopsy specimens of the nasal tumor (hematoxylin-eosin, original magnification ×40). A, Nests of small, round, blue cells; scattered brown pigment; and prominent fibrillary background. B, A fibrillary background or collection of dendritic processes.

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Figure 2.

Immunostaining of the biopsy specimens shown in Figure 1 (original magnification ×40). A, Immunostaining for S-100 protein. B, Immunostaining for neural cell adhesion molecule (CD56).

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Figure 3.

Electron microscopy of the nasal tumor. A, Large numbers of neurosecretory granules. B, Higher magnification of neurosecretory granules.

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