PMID- 24061523
OWN - NLM
STAT- MEDLINE
DCOM- 20131231
LR  - 20230202
IS  - 1532-0979 (Electronic)
IS  - 0147-5185 (Linking)
VI  - 37
IP  - 12
DP  - 2013 Dec
TI  - Ambiguous melanocytic tumors in a tertiary referral center: the contribution of 
      fluorescence in situ hybridization (FISH) to conventional histopathologic and 
      immunophenotypic analyses.
PG  - 1783-96
LID - 10.1097/PAS.0b013e31829d20f5 [doi]
AB  - The diagnosis of benign versus malignant melanocytic proliferations remains an 
      important challenge. The current diagnostic algorithm typically involves an 
      assessment of histopathologic and immunohistochemical parameters by light 
      microscopy. Recently, fluorescence in situ hybridization (FISH) was reported as a 
      useful ancillary diagnostic tool in melanocytic lesions, but the utility of FISH 
      in melanocytic tumors that are difficult to diagnose with standard morphologic 
      analysis remains controversial. To address this issue, we collected 34 ambiguous 
      melanocytic tumors for FISH testing (NeoGenomics). Before FISH testing, cases 
      were designated as "favor benign" (n=24) or "favor malignant" (n=10) by a 
      consensus group (up to 7 dermatopathologists) on the basis of clinical, 
      histopathologic, and immunophenotypic parameters. FISH was positive in 3/24 
      "favor benign" lesions and in 5/10 "favor malignant" lesions. The 
      histopathologic, immunophenotypic, and FISH parameters informing our diagnostic 
      impression were correlated with the final consensus diagnosis and clinical 
      follow-up; in all cases, the initial diagnosis remained unchanged. In this 
      series, the sensitivity of FISH for the histopathologic diagnosis of melanoma was 
      50%, the specificity was 87.5%, the positive predictive value was 62.5%, and the 
      negative predictive value was 80.7%. Follow-up information was available for 25 
      patients (17 benign and 8 malignant diagnoses). Among benign lesions, the mean 
      follow-up was 16.8 months (range, 8 to 25 mo); no metastases have been reported 
      to date. Among the malignant lesions, the mean follow-up was 14.6 months (range, 
      7 to 23 mo); a single lymph node metastasis was identified in a 4-year-old girl 
      with a histopathologic diagnosis of melanoma, which was negative on FISH. In our 
      experience, in the setting of a lesion with predominantly benign findings, a 
      negative FISH test-given its high specificity-is a reassuring finding that 
      supports a benign diagnosis. In contrast, a positive FISH test should be 
      carefully interrogated in the context of the complete histopathologic findings.
FAU - Tetzlaff, Michael T
AU  - Tetzlaff MT
AD  - *Department of Pathology, Section of Dermatopathology daggerDepartment of 
      Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
FAU - Wang, Wei-Lien
AU  - Wang WL
FAU - Milless, Tiffani L
AU  - Milless TL
FAU - Curry, Jonathan L
AU  - Curry JL
FAU - Torres-Cabala, Carlos A
AU  - Torres-Cabala CA
FAU - McLemore, Michael S
AU  - McLemore MS
FAU - Ivan, Doina
AU  - Ivan D
FAU - Bassett, Roland L
AU  - Bassett RL
FAU - Prieto, Victor G
AU  - Prieto VG
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Surg Pathol
JT  - The American journal of surgical pathology
JID - 7707904
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Immunophenotyping
MH  - *In Situ Hybridization, Fluorescence
MH  - Male
MH  - Melanoma/*diagnosis
MH  - Middle Aged
MH  - Sensitivity and Specificity
MH  - Tertiary Care Centers
MH  - Young Adult
EDAT- 2013/09/26 06:00
MHDA- 2014/01/01 06:00
CRDT- 2013/09/25 06:00
PHST- 2013/09/25 06:00 [entrez]
PHST- 2013/09/26 06:00 [pubmed]
PHST- 2014/01/01 06:00 [medline]
AID - 10.1097/PAS.0b013e31829d20f5 [doi]
PST - ppublish
SO  - Am J Surg Pathol. 2013 Dec;37(12):1783-96. doi: 10.1097/PAS.0b013e31829d20f5.