There has been a case report of exaggerated pigmented granulomatous reaction to the artificial joint implant in a 72-year-old man who had undergone bilateral total hip arthroplasty, in whom, aspirate from the inguinal region was misinterpreted as metastatic melanoma from an unknown primary. Microscopically, the smears of this patient showed both intracellular and extracellular black pigment with obscured cytomorphology; although, appreciable cells were reported to be pleomorphic with prominent nucleoli. The patient had no evidence of primary cutaneous melanoma. On surgical exploration and histologic examination, what was presumed to be the bulky enlarged lymph nodes was found to be the soft tissue with pigment-laden macrophages and granulomatous reaction that.
