{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:46:09Z","timestamp":1779299169477,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Merkel cell carcinoma (MCC) is a rare, highly aggressive neuroendocrine carcinoma of the skin, associated with immunosuppression, UV light exposure, and the Merkel cell polyomavirus (MCPyV). Cases of metastatic MCC diagnosed in body fluid cytology are extremely rare; only five cases have been reported previously in the English literature. We present a case of a 65\u2010year\u2010old male with acute respiratory failure and an enlarged right pleural effusion. He had two hospitalizations for COVID\u201019 pneumonia 2\u00a0months prior, for which he received steroid treatment and tocilizumab. Emergent thoracentesis was done, with pleural fluid sent for cytologic evaluation. Both the Papanicolaou stained ThinPrep slide and cell block demonstrated clusters of predominantly small to medium sized blue round cells with hyperchromatic nuclei, scant cytoplasm and fine chromatin, in a background of rare mesothelial cells, macrophages and numerous lymphocytes. Tumor cells were positive for CD56, chromogranin, synaptophysin, SAT2B, MCPyV, and CK20 in perinuclear dot like pattern, while negative for TTF\u20101 and CD45 immunostains. Ki67 proliferative index was approximately 40%. The patient had a history of MCC of the right ulnar forearm 4\u2009years before the current presentation, which was unknown to us at the time of cytologic evaluation. To the best of our knowledge, this is the sixth case of metastatic MCC diagnosed by fluid cytology and the first reported in a patient receiving immunosuppressive treatment for COVID\u201019. Further reporting of such cases may increase awareness, especially when prior history is not readily available, such as in our case.<\/jats:p>","DOI":"10.1002\/dc.24882","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T14:57:25Z","timestamp":1633618645000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Merkel cell carcinoma presenting as a malignant pleural effusion <scp>post\u2010COVID<\/scp>\u201019 hospitalization: A case report and literature review"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2243-2659","authenticated-orcid":false,"given":"Joel","family":"Lanceta","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Northwell Health\u2010Staten Island University Hospital  New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mesut","family":"Toprak","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Northwell Health\u2010Staten Island University Hospital  New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oana C.","family":"Rosca","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Northwell Health\u2010Staten Island University Hospital  New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1972.01620040075020"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30364-3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896919880260"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5266-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2010.01.001"},{"key":"e_1_2_7_7_1","first-page":"e58950","article-title":"Merkel cell polyomavirus infection and detection","volume":"144","author":"Liu W","year":"2019","journal-title":"J Vis Exp"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.10.022"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1152586"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13943"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0155-y"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.12.004"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12947"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.4132\/jptm.2017.11.10"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6413-1-5"},{"issue":"3","key":"e_1_2_7_16_1","first-page":"397","article-title":"Cytology of metastatic neuroendocrine (Merkel\u2010cell) carcinoma in pleural fluid. A case report","volume":"29","author":"Watson CW","year":"1985","journal-title":"Acta Cytol"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/1742-6413.162775"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001232"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001432"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001536"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2011.06.011"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12176"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e31819821e8"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-018-0898-2"},{"issue":"2","key":"e_1_2_7_25_1","first-page":"81","article-title":"Merkel cell carcinoma in a patient treated with adalimumab: case report","volume":"87","author":"Krishna SM","year":"2011","journal-title":"Cutis"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2017.06.028"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2015-000213"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X18798462"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2019.03.002"},{"key":"e_1_2_7_30_1","unstructured":"Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID\u201019 (Accessed on May 11 2021)."}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.24882","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.24882","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.24882","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T09:28:04Z","timestamp":1693214884000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.24882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,5]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/dc.24882"],"URL":"https:\/\/doi.org\/10.1002\/dc.24882","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,5]]},"assertion":[{"value":"2021-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}