Is Merkel Cell Carcinoma of Lymph Node Actually Metastatic Cutaneous Merkel Cell Carcinoma?

Author:

Lawrence Lauren E B1ORCID,Saleem Atif1,Sahoo Malaya K1,Tan Susanna K2,Pinsky Benjamin A12,Natkunam Yasodha1,Kunder Christian A1ORCID,Stehr Henning1,Zehnder James L1

Affiliation:

1. Department of Pathology, Stanford University School of Medicine, Stanford, CA

2. Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA

Abstract

Abstract Objectives The possibility of a so-called primary lymph node neuroendocrine carcinoma has been described in the literature. Here we evaluate cases fitting such a diagnosis and find that the cases demonstrate a convincing and pervasive pattern consistent with metastatic Merkel cell carcinoma. Methods Six cases of primary lymph node Merkel cell carcinoma and one case of metastatic neuroendocrine carcinoma at a bony site, all with unknown primary, were sequenced using a combination of whole-exome and targeted panel methods. Sequencing results were analyzed for the presence of an ultraviolet (UV) mutational signature or off-target detection of Merkel cell polyomavirus (MCPyV). Results Four of six primary lymph node cases were positive for a UV mutational signature, with the remaining two cases positive for off-target alignment of MCPyV. One case of neuroendocrine carcinoma occurring at a bony site was also positive for a UV mutational signature. Conclusions We find no evidence to corroborate the existence of so-called primary Merkel cell carcinoma of lymph node.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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