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Histopathologic, Immunohistochemical, and Cytogenetic Analysis of Primary Clear Cell Melanoma of the Uvea

Robert M. Verdijk, MD, PhD; Anna E. Koopmans, MD; Emine Kilic, MD, PhD; Dion Paridaens, MD, PhD; Annelies de Klein, PhD
JAMA Ophthalmol. 2013;131(6):814-816. doi:10.1001/jamaophthalmol.2013.1939.
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The histologic findings of malignant melanoma may be highly variable, and the tumor can mimic many other neoplasms.1 We describe a case of clear cell uveal melanoma. Cytoplasmic clear cell change of uveal melanoma cells can be observed as balloon cells,1 clear cells,2 and signet ring cells.1 The histologic differential diagnosis has to be made with metastatic clear cell carcinomas, seminoma, and clear cell sarcoma as well as xanthomatous cells.

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Figure. Ultrasonographic, histologic, and immunohistochemical appearance of the tumor. A, B-scan ultrasonography of the tumor shows a dome-shaped subretinal mass in the posterior pole. B, The tumor was mainly composed of spindle and irregular polygonal cells with distinct borders and a clear cytoplasm that sometimes contained brown pigment. The cells were interspersed in a delicate capillary network. Nuclei were enlarged with coarse open chromatin and prominent irregular nucleoli (hematoxylin-eosin, original magnification ×630). C, The cytoplasm stained positive for periodic acid–Schiff sensitive to diastase treatment (original magnification ×630). D, The cells stained positive for the melanocytic marker HMB-45 (original magnification ×400).

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