CLF - Deep Dive Layout
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While an MCC on the skin can look like a cyst or folliculitis lesion, it is easily identifiable under the microscope as a cancer of the ‘small blue round cell’ category. When a lesion falls into this category, the pathologist almost always orders a set of tests (as described below) to narrow down a diagnosis. In the vast majority of cases, the pattern of CK20 and other tests makes the diagnosis of MCC quite easy for the pathologist.
MCC will typically be positive for:
- low molecular weight cytokeratins (CAM 5.2 or AE1/AE3)
- CK20, or
- neuron-specific enolase (NSE)
MCC is not typically positive for:
- CK7 or thyroid transcription factor 1 (TTF-1) (positive in SCLC)
- leukocyte common antigen (LCA) (positive in lymphoma), or
- S100 (positive in small cell melanoma)
By nature, Merkel cells cannot divide or grow. Therefore, research suggests that MCC does not arise directly from mature Merkel cells, but rather from precursor cells—skin cells at the earliest stages of development that divide quickly and later become Merkel cells. It is when these precursor cells become cancerous that they grow into what is eventually MCC.
For more detailed information: View related clinical publications and scientific research