Malignant melanoma arising primarily in the vagina is extremely rare and only about 30 cases have been reported to date. There are no cytological details in all of these reports, except for 2 cases.
We have made cytological examination in one case of primary malignant melanoma of the vagina in a 65-year-old woman. Chief complaint was geni tal bleeding. A tumor was found in the vagina, as shown in Fig. 1, by initial examination and the tumor was diagnosed as malignant melanoma by means of punching biopsy and scraping smear from the surface of the tumor. Extrication of the tumor and irradiation treatment were carried out. About one month later, radical hysterectomy was carried out and metastasis was not found in any of the lymph nodes by pathological examination.
This case is now under observation and recurre nce of malignant melanoma has been noticed in vu-Ivo-vaginal region in the latest examination.
Most of the cells in the smears were bizarre cells, as shown in Fig. 2-5, and their characteristics are as follows
A) Aggregation of cell and size
1) Scattering, no tendency of grouping
2) Anisocytosis and anisokaryosis
B) Cytoplasm of cell and N/C ratio
1) Acidophilic cytoplasm
2) Melanin pigmentation
3) Low N/C ratio, relatively aboundant cyto-plasm
C) Nucleus
1) Extremely eccentric nucleus
2) Thin and irregular nuclear membrane
3) Even chromatin distribution (some cells have chromatin clumping)
4) Prominent nucleoli
5) Giant malignant cells
6) Vacuoles in nuclei
7) Mitosis
Examination of scraping smears by DOPA reac - tion showed the presence of tyrosinase activity in all the atypical cells without melanin pigmentation, which resemble the cells of sarcoma, especially of reticulosarcoma.
抄録全体を表示