Which histologic findings are characteristic of ciliary body melanoma?

Updated: Mar 03, 2020
  • Author: Enrique Garcia-Valenzuela, MD, PhD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Histologic evaluation of the tumor after enucleation can confirm the diagnosis and evaluate prognosis. Three distinct cell types are recognized in uveal melanomas, spindle A, spindle B, and epithelioid.

Spindle A cells have elongated nuclei and, uncommonly, have mitotic figures.

Spindle B cells have an elongated profile, but they are slightly larger than spindle A cells and have prominent nucleoli. They are found more commonly than are spindle A cells.

Epithelioid melanoma cells are highly anaplastic and poorly cohesive, and they have considerable morphologic variation. They tend to resemble epithelial cells and to contain frequent mitotic figures.

Evaluation of vascular supply of the tumor, age at presentation, presence of extrascleral extension, tumor size, tumor cell types, mitotic rate, nucleolar area, and quantification of nucleolar organizer regions have been used for prognostic purposes.

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