PMID- 24618603
OWN - NLM
STAT- MEDLINE
DCOM- 20140626
LR  - 20191210
IS  - 1532-0979 (Electronic)
IS  - 0147-5185 (Linking)
VI  - 38
IP  - 6
DP  - 2014 Jun
TI  - Fluorescence in situ hybridization as an ancillary tool in the diagnosis of 
      ambiguous melanocytic neoplasms: a review of 804 cases.
PG  - 824-31
LID - 10.1097/PAS.0000000000000189 [doi]
AB  - Previous studies have demonstrated the utility of fluorescence in situ 
      hybridization (FISH) as an ancillary method in the diagnostic workup of 
      histopathologically ambiguous melanocytic neoplasms. A combination of probes 
      targeting 3 loci on chromosome 6 and 1 on 11q has been reported to distinguish 
      unequivocal melanomas and nevi with a sensitivity and specificity of 87% and 96%, 
      respectively. However, information on how FISH should be integrated into routine 
      clinical testing is limited. We report our experience of FISH testing of 804 
      ambiguous melanocytic lesions performed as part of routine workup at University 
      of California, San Francisco. The main category (47% of all cases) for which FISH 
      testing was requested was Spitz tumors. Other categories included the distinction 
      of possible melanoma from combined nevi (9%), acral or mucosal nevi (9%), 
      Clark/dysplastic nevi (7%), and blue or deep penetrating nevi (6%) and to assess 
      the possibility of nevoid melanoma (4%). Of the ambiguous tumors successfully 
      tested, 88% received a more definitive benign or malignant final diagnosis. Of 
      the 630 cases that tested negative by FISH, the final diagnosis was benign in 489 
      (78%) cases, ambiguous in 91 cases (14%), and malignant in 50 cases (8%). A 
      positive FISH result was observed in 124 cases, with a final diagnosis of 
      melanoma in 117 (94%). One (1%) FISH-positive case had an equivocal final 
      diagnosis, and 6 (5%) were interpreted, despite the positive FISH result, as 
      melanocytic nevi. We conclude that FISH testing can help reduce the number of 
      equivocal diagnoses in ambiguous melanocytic neoplasms, in particular if FISH 
      testing is positive, and discuss the challenges and limitations of FISH in 
      clinical practice.
FAU - North, Jeffrey P
AU  - North JP
AD  - Departments of *Pathology daggerDermatology double daggerThe Helen Diller Comprehensive Cancer 
      Center, University of California, San Francisco, CA.
FAU - Garrido, Maria C
AU  - Garrido MC
FAU - Kolaitis, Nicholas A
AU  - Kolaitis NA
FAU - LeBoit, Philip E
AU  - LeBoit PE
FAU - McCalmont, Timothy H
AU  - McCalmont TH
FAU - Bastian, Boris C
AU  - Bastian BC
LA  - eng
GR  - R01-CA131524/CA/NCI NIH HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Am J Surg Pathol
JT  - The American journal of surgical pathology
JID - 7707904
SB  - IM
MH  - Adolescent
MH  - Aged
MH  - *Chromosomes, Human, Pair 11
MH  - *Chromosomes, Human, Pair 6
MH  - Cluster Analysis
MH  - Female
MH  - Genetic Predisposition to Disease
MH  - Humans
MH  - *In Situ Hybridization, Fluorescence
MH  - Male
MH  - *Melanocytes/pathology
MH  - Middle Aged
MH  - Nevus, Epithelioid and Spindle Cell/*genetics/pathology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - San Francisco
MH  - Skin Neoplasms/*genetics/pathology
EDAT- 2014/03/13 06:00
MHDA- 2014/06/27 06:00
CRDT- 2014/03/13 06:00
PHST- 2014/03/13 06:00 [entrez]
PHST- 2014/03/13 06:00 [pubmed]
PHST- 2014/06/27 06:00 [medline]
AID - 10.1097/PAS.0000000000000189 [doi]
PST - ppublish
SO  - Am J Surg Pathol. 2014 Jun;38(6):824-31. doi: 10.1097/PAS.0000000000000189.