PMC3687165_01
Ulcerated lesion along the left lateral border of the tongue
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F1
Clinical examination showed an ulcerated lesion of 6 x 6 cm, present along the left lateral border of the tongue extending from the base to the tip [Figure 1].
Sheets and nests of tumor cells involving the dermoepidermal junction (H and E, x40)
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F2
On microscopy, tumor cells were seen involving the dermoepidermal junction and composed of sheets and nests of cells separated by scant fibrous stroma [Figure 2].
(a) Spindle shaped tumor cells (b) Epitheloid tumor cells with prominent nucleoli and tumor giant cells (H and E, x400)
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F3
In focal areas, the cells were spindle shaped and also epitheloid [Figure 3].
Immunostain for HMB-45 showing strong positivity (IHC, x100)
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F4
However, the tumor cells showed strong diffuse positivity for Human Melanoma Black 45 (HMB) [Figure 4] confirming the diagnosis of malignant (amelanotic) melanoma of the tongue with metastases to the left cervical lymph node.