PMID- 21496703
OWN - NLM
STAT- MEDLINE
DCOM- 20110630
LR  - 20220309
IS  - 1097-6787 (Electronic)
IS  - 0190-9622 (Linking)
VI  - 64
IP  - 5
DP  - 2011 May
TI  - Atypical Spitzoid melanocytic tumors: a morphological, mutational, and FISH 
      analysis.
PG  - 919-35
LID - 10.1016/j.jaad.2010.05.043 [doi]
AB  - BACKGROUND: Identification of the clinical behavior of atypical Spitzoid tumors 
      with conflicting histopathologic features remains controversial. OBJECTIVE: We 
      sought to assess whether molecular findings may be helpful in the diagnostic and 
      prognostic assessment of atypical Spitzoid tumors. METHODS: A total of 38 
      controversial, atypical Spitzoid lesions (>/= 1 mm in thickness) were analyzed for 
      clinicopathological features, chromosomal alterations by fluorescence in situ 
      hybridization (FISH) analysis (RREB1/MYB/CCND1/CEP6), BRAF(V600E) mutation by 
      allele-specific real-time polymerase chain reaction confirmed by sequencing, and 
      H-RAS gene mutation by direct sequencing. RESULTS: Atypical Spitzoid lesions 
      developed in 21 female and 17 male patients (mean age 22 years). Nine patients 
      underwent sentinel lymph node biopsy and a sentinel lymph node micrometastasis 
      was detected in 4 of these 9 cases. Four additional patients, who did not receive 
      a sentinel lymph node biopsy, experienced bulky lymph node metastases and one 
      experienced visceral metastases and death. Lesions from patients with lymph node 
      involvement showed more deep mitoses (P < .01), less inflammation (P = .05), and 
      more plasma cells (P = .04). FISH analysis demonstrated the presence of 
      chromosomal alterations in 6 of 25 cases. Correlation with follow-up data showed 
      that the only case with fatal outcome showed multiple chromosomal alterations by 
      FISH analysis. BRAF(V600E) mutation was detected in 12 of 16 cases (75%) and 
      H-RAS mutation on exon 3 was found in 3 of 11 cases (27%). LIMITATIONS: Our 
      results require validation in a larger series with longer follow-up information. 
      CONCLUSIONS: FISH assay may be of help in the prognostic evaluation of atypical 
      Spitzoid tumors. Diagnostic significance of BRAF(V600E) and H-RAS mutations in 
      this setting remains unclear.
CI  - Copyright (c) 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. 
      All rights reserved.
FAU - Massi, Daniela
AU  - Massi D
AD  - Division of Pathological Anatomy, Department of Critical Care Medicine and 
      Surgery, University of Florence, Florence, Italy. Daniela.massi@UNIFI.IT
FAU - Cesinaro, Anna Maria
AU  - Cesinaro AM
FAU - Tomasini, Carlo
AU  - Tomasini C
FAU - Paglierani, Milena
AU  - Paglierani M
FAU - Bettelli, Stefania
AU  - Bettelli S
FAU - Dal Maso, Luigino
AU  - Dal Maso L
FAU - Simi, Lisa
AU  - Simi L
FAU - Salvianti, Francesca
AU  - Salvianti F
FAU - Pinzani, Pamela
AU  - Pinzani P
FAU - Orlando, Claudio
AU  - Orlando C
FAU - De Giorgi, Vincenzo
AU  - De Giorgi V
FAU - Lukic, Silvana
AU  - Lukic S
FAU - Maiorana, Antonio
AU  - Maiorana A
FAU - Santucci, Marco
AU  - Santucci M
FAU - Canzonieri, Vincenzo
AU  - Canzonieri V
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
RN  - 0 (lymph node revealing solution)
RN  - 0F5N573A2Y (Ether)
RN  - 1HG84L3525 (Formaldehyde)
RN  - 3K9958V90M (Ethanol)
RN  - EC 2.7.11.1 (BRAF protein, human)
RN  - EC 2.7.11.1 (Proto-Oncogene Proteins B-raf)
RN  - Q40Q9N063P (Acetic Acid)
SB  - IM
MH  - Acetic Acid
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Chromatography
MH  - Dermoscopy
MH  - Ethanol
MH  - Ether
MH  - Female
MH  - Formaldehyde
MH  - Genes, ras/genetics
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - Nevus, Epithelioid and Spindle Cell/*genetics/*pathology
MH  - Prognosis
MH  - Proto-Oncogene Proteins B-raf/genetics
MH  - Skin Neoplasms/*genetics/*pathology
MH  - Young Adult
EDAT- 2011/04/19 06:00
MHDA- 2011/07/01 06:00
CRDT- 2011/04/19 06:00
PHST- 2010/03/04 00:00 [received]
PHST- 2010/04/26 00:00 [revised]
PHST- 2010/05/13 00:00 [accepted]
PHST- 2011/04/19 06:00 [entrez]
PHST- 2011/04/19 06:00 [pubmed]
PHST- 2011/07/01 06:00 [medline]
AID - S0190-9622(10)00686-9 [pii]
AID - 10.1016/j.jaad.2010.05.043 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 2011 May;64(5):919-35. doi: 10.1016/j.jaad.2010.05.043.