TY - JOUR
T1 - BRAF Mutated and Morphologically Spitzoid Tumors, a Subgroup of Melanocytic Neoplasms Difficult to Distinguish from True Spitz Neoplasms
AU - Gerami, Pedram
AU - Chen, Alice
AU - Sharma, Natasha
AU - Patel, Pragi
AU - Hagstrom, Michael
AU - Kancherla, Pranav
AU - Geraminejad, Tara
AU - Olivares, Shantel
AU - Biswas, Asok
AU - Bosenberg, Marcus
AU - Busam, Klaus J.
AU - De La Fouchardière, Arnaud
AU - Duncan, Lyn M.
AU - Elder, David E.
AU - Ko, Jennifer
AU - Landman, Gilles
AU - Lazar, Alexander J.
AU - Lowe, Lori
AU - Massi, Daniela
AU - Mihic-Probst, Daniela
AU - Parker, Douglas C.
AU - Scolyer, Richard A.
AU - Shea, Christopher R.
AU - Zembowicz, Artur
AU - Yun, Sook Jung
AU - Blokx, Willeke A.M.
AU - Barnhill, Raymond L.
N1 - Publisher Copyright:
© 2024 Wolters Kluwer Health. All rights reserved.
PY - 2024/5/1
Y1 - 2024/5/1
N2 - Drivers of Spitz neoplasms include activating point mutations in HRAS and Spitz-Associated genomic fusions. It has become evident that some BRAF-mutated melanocytic neoplasms can morphologically mimic Spitz tumors (STs). These have been termed BRAF mutated and morphologically spitzoid (BAMS). In this study, 17 experts from the International Melanoma Pathology Study Group assessed 54 cases which included 40 BAMS and 14 true STs. The participants reviewed the cases blinded to the genomic data and selected among several diagnostic options, including BAMS, ST, melanoma, and other. A total of 38% of all diagnostic selections in the BAMS cases were for BAMS, whereas 32% were for ST. In 22 of the BAMS cases, the favored diagnosis was BAMS, whereas in 17 of the BAMS cases, the favored diagnosis was ST. Among the 20 cases in the total group of 54 with the highest number of votes for ST, half were BAMS. Of BAMS, 75% had a number of votes for ST that was within the SD of votes for ST seen among true ST cases. There was poor interobserver agreement for the precise diagnosis of the BAMS (kappa = 0.16) but good agreement that these cases were not melanoma (kappa = 0.7). BAMS nevi/tumors can closely mimic Spitz neoplasms. Expert melanoma pathologists in this study favored a diagnosis of ST in nearly half of the BAMS cases. There are BAMS cases that even experts cannot morphologically distinguish from true Spitz neoplasms.
AB - Drivers of Spitz neoplasms include activating point mutations in HRAS and Spitz-Associated genomic fusions. It has become evident that some BRAF-mutated melanocytic neoplasms can morphologically mimic Spitz tumors (STs). These have been termed BRAF mutated and morphologically spitzoid (BAMS). In this study, 17 experts from the International Melanoma Pathology Study Group assessed 54 cases which included 40 BAMS and 14 true STs. The participants reviewed the cases blinded to the genomic data and selected among several diagnostic options, including BAMS, ST, melanoma, and other. A total of 38% of all diagnostic selections in the BAMS cases were for BAMS, whereas 32% were for ST. In 22 of the BAMS cases, the favored diagnosis was BAMS, whereas in 17 of the BAMS cases, the favored diagnosis was ST. Among the 20 cases in the total group of 54 with the highest number of votes for ST, half were BAMS. Of BAMS, 75% had a number of votes for ST that was within the SD of votes for ST seen among true ST cases. There was poor interobserver agreement for the precise diagnosis of the BAMS (kappa = 0.16) but good agreement that these cases were not melanoma (kappa = 0.7). BAMS nevi/tumors can closely mimic Spitz neoplasms. Expert melanoma pathologists in this study favored a diagnosis of ST in nearly half of the BAMS cases. There are BAMS cases that even experts cannot morphologically distinguish from true Spitz neoplasms.
KW - BRAF
KW - Spitz melanoma
KW - Spitz nevi
KW - atypical Spitz tumors
KW - dysplastic nevi
KW - melanoma
UR - http://www.scopus.com/inward/record.url?scp=85190790064&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85190790064&partnerID=8YFLogxK
U2 - 10.1097/PAS.0000000000002194
DO - 10.1097/PAS.0000000000002194
M3 - Article
C2 - 38525831
AN - SCOPUS:85190790064
SN - 0147-5185
VL - 48
SP - 538
EP - 545
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
IS - 5
ER -