TY - JOUR
T1 - Atypical spitz tumors with 6q23 deletions
T2 - A clinical, histological, and molecular study
AU - Shen, Lisa
AU - Cooper, Chelsea
AU - Bajaj, Shirin
AU - Liu, Ping
AU - Pestova, Ekaterina
AU - Guitart, Joan
AU - Gerami, Pedram
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2013/12
Y1 - 2013/12
N2 - ABSTRACT:: Determining risk assessment for aggressive behavior of atypical Spitz tumors (ASTs) remains a significant challenge for pathologists. Despite the presence of many concerning histological features such as tumor ulceration, expansile growth, dermal mitotic rate, and cytological atypia, the overwhelming majority of these tumors behave in an indolent fashion. Recently, we have noted that using cytogenetics, one can identify ASTs with high likelihood for aggressive behavior allowing for a clinically significant risk assessment. In this retrospective case-controlled study, we examined the clinical and histological features of 24 cases of ASTs that were found to have isolated copy number deletions in 6q23 when studied by probes targeting 6p25, 6q23, Cep6, 11q13, 9p21, and Cep9. Although 6 of 11 patients had a positive sentinel node biopsy, none of the patients developed tumor in a nonsentinel node, palpable adenopathy, in transit metastasis, or distant metastasis. Histopathologically, the tumors showed minimal pagetoid spread (P = 0.004) and trended toward a histological presentation with expansile nodular growth (P = 0.08) and focal ulceration (P = 0.19). Furthermore, we also depict and illustrate the challenges that may occur in accurately identifying 6q23 deletions using fluorescence in situ hybridization in ASTs.
AB - ABSTRACT:: Determining risk assessment for aggressive behavior of atypical Spitz tumors (ASTs) remains a significant challenge for pathologists. Despite the presence of many concerning histological features such as tumor ulceration, expansile growth, dermal mitotic rate, and cytological atypia, the overwhelming majority of these tumors behave in an indolent fashion. Recently, we have noted that using cytogenetics, one can identify ASTs with high likelihood for aggressive behavior allowing for a clinically significant risk assessment. In this retrospective case-controlled study, we examined the clinical and histological features of 24 cases of ASTs that were found to have isolated copy number deletions in 6q23 when studied by probes targeting 6p25, 6q23, Cep6, 11q13, 9p21, and Cep9. Although 6 of 11 patients had a positive sentinel node biopsy, none of the patients developed tumor in a nonsentinel node, palpable adenopathy, in transit metastasis, or distant metastasis. Histopathologically, the tumors showed minimal pagetoid spread (P = 0.004) and trended toward a histological presentation with expansile nodular growth (P = 0.08) and focal ulceration (P = 0.19). Furthermore, we also depict and illustrate the challenges that may occur in accurately identifying 6q23 deletions using fluorescence in situ hybridization in ASTs.
KW - Atypical spitz tumor
KW - Fluorescence in situ hybridization
KW - Melanoma
KW - Spitz nevus
KW - Spitz tumor
KW - Spitzoid melanoma
UR - http://www.scopus.com/inward/record.url?scp=84890860123&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890860123&partnerID=8YFLogxK
U2 - 10.1097/DAD.0b013e31828671bf
DO - 10.1097/DAD.0b013e31828671bf
M3 - Article
C2 - 23455333
AN - SCOPUS:84890860123
SN - 0193-1091
VL - 35
SP - 804
EP - 812
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 8
ER -