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Atypical spitz tumor

Ge Zhao, Kachiu C Lee, Sue Peacock, Lisa M Reisch, Stevan R Knezevich, David E Elder, Michael W Piepkorn, Joann G Elmore, Raymond L Barnhill
BACKGROUND: Spitz nevi, atypical Spitz tumors and spitzoid melanomas ("spitzoid lesions") represent controversial and poorly understood cutaneous melanocytic lesions that are difficult to diagnose histologically. It is unknown how these terms are used by pathologists. METHODS: We describe use of Spitz-related terminology using data from the Melanoma Pathology (M-Path) study database comprising pathologists' interpretations of biopsy slides, a nation-wide study evaluating practicing U...
September 30, 2016: Journal of Cutaneous Pathology
Nicholas Latchana, Kelly Regan, John Harrison Howard, Jennifer H Aldrink, Mark A Ranalli, Sara B Peters, Xiaoli Zhang, Alejandro Gru, Philip R O Payne, Lorena P Suarez-Kelly, William E Carson
BACKGROUND: Melanoma skin cancer remains the leading cause of skin cancer-related deaths. Spitz lesions represent a subset of melanocytic skin lesions characterized by epithelioid or spindled melanocytes organized in nests. These lesions occupy a spectrum ranging from benign Spitz and atypical Spitz lesions all the way to malignant Spitz tumors. Appropriate management is reliant on accurate diagnostic classification, yet this effort remains challenging using current light microscopic techniques...
October 2016: Journal of Surgical Research
Paul W Harms, Thomas L Hocker, Lili Zhao, May P Chan, Aleodor A Andea, Min Wang, Kelly L Harms, Michael L Wang, Shannon Carskadon, Nallasivam Palanisamy, Douglas R Fullen
Spitzoid melanocytic lesions, including Spitz nevi (benign), spitzoid melanoma (malignant), and borderline atypical Spitz tumors (ASTs), frequently present challenges for accurate diagnosis and prognosis. Evaluation for loss of the tumor suppressor p16, encoded by CDKN2A gene on chromosome 9p21.3, has been proposed to be useful for evaluation of spitzoid melanocytic lesions. However, reports on the utility of p16 immunohistochemistry for spitzoid lesions have been conflicting, and few studies have directly compared p16 immunohistochemistry with fluorescence in situ hybridization (FISH) for CDKN2A genomic status...
August 25, 2016: Human Pathology
Rossitza Lazova, Erin H Seeley, Heinz Kutzner, Richard A Scolyer, Glynis Scott, Lorenzo Cerroni, Isabella Fried, Milena E Kozovska, Arlene S Rosenberg, Victor G Prieto, Bahig M Shehata, Megan M Durham, Gina Henry, Jose L Rodriguez-Peralto, Erica Riveiro-Falkenbach, Jochen T Schaefer, Richard Danialan, Sylvie Fraitag, Sonja Vollenweider-Roten, Alireza Sepehr, Martin Sangueza, Nouf Hijazi, Yamile Corredoira, Rachel Kowal, Olga M Harris, Francisco Bravo, Alan S Boyd, Ralitza Gueorguieva, Richard M Caprioli
BACKGROUND: Previously, using imaging mass spectrometry (IMS), we discovered proteomic differences between Spitz nevi and Spitzoid melanomas. OBJECTIVE: We sought to determine whether IMS can assist in the classification of diagnostically challenging atypical Spitzoid neoplasms (ASN), to compare and correlate the IMS and histopathological diagnoses with clinical behavior. METHODS: We conducted a retrospective collaborative study involving centers from 11 countries and 11 US institutions analyzing 102 ASNs by IMS...
August 5, 2016: Journal of the American Academy of Dermatology
Roberto Cecchi, Laura Bartoli, Luigi Brunetti, Giovanni Troiano, Cataldo DE Gaudio, Stefania Innocenti
No abstract text is available yet for this article.
August 2016: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Carmelo Urso
BACKGROUND: Spitzoid neoplasms may pose significant diagnostic problems because in a fraction of them it is quite difficult or impossible to establish if they are benign or malignant lesions. An extraordinarily large number of studies have been made in attempts to solve this problem; regrettably, the histological criteria proposed and the various special sophisticated techniques employed have proven to be ineffective in making this distinction with confidence. OBJECTIVES: To explore the possible causes for this diagnostic failure and an attempt to identify the source of this problem...
April 2016: Dermatology Practical & Conceptual
Jeong Hee Cho-Vega
Atypical spitzoid tumors are a morphologically diverse group of rare melanocytic lesions most frequently seen in children and young adults. As atypical spitzoid tumors bear striking resemblance to Spitz nevus and spitzoid melanomas clinically and histopathologically, it is crucial to determine its malignant potential and predict its clinical behavior. To date, many researchers have attempted to differentiate atypical spitzoid tumors from unequivocal melanomas based on morphological, immonohistochemical, and molecular diagnostic differences...
July 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Maija Kiuru, Achim Jungbluth, Heinz Kutzner, Thomas Wiesner, Klaus J Busam
Spitz tumors are a group of melanocytic neoplasms with distinct morphological features that tend to affect young individuals. Distinguishing benign from malignant Spitz tumors can be challenging, but cytogenetic and molecular tests have contributed to improvements in diagnostic accuracy. Spitz tumors harbor diverse genetic alterations, including mutations in HRAS, loss of BAP1, or kinase fusions in ROS1, NTRK1, ALK, BRAF, and RET genes. Limited data exist on the correlation between histopathological features and kinase fusions...
May 2016: International Journal of Surgical Pathology
Gérald E Piérard, Claudine Piérard-Franchimont, Philippe Delvenne
During the recent period, dermoscopy has yielded improvement in the early disclosure of various atypical melanocytic neoplasms (AMN) of the skin. Beyond this clinical procedure, AMN histopathology remains mandatory for establishing their precise diagnosis. Of note, panels of experts in AMN merely report moderate agreement in various puzzling cases. Divergences in opinion and misdiagnosis are likely increased when histopathological criteria are not fine-tuned and when facing a diversity of AMN types. Furthermore, some AMN have been differently named in the literature including atypical Spitz tumor, metastasizing Spitz tumor, borderline and intermediate melanocytic tumor, malignant Spitz nevus, pigmented epithelioid melanocytoma or animal-type melanoma...
February 10, 2015: Oncology Reviews
J Bauer
Melanoma therapy has undergone a paradigm shift. Classic chemotherapies with poor treatment responses have been replaced by modern immune checkpoint blockades and targeted therapies with excellent responses. The latter require precise diagnosis of mutations in the melanoma genome as molecular targets for the small molecules. The diagnosis of melanomas has also been supplemented by molecular techniques. Differential diagnosis of melanoma and melanoma simulators such as atypical Spitz nevi can be supported by fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH)...
January 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Elvira Moscarella, Aimilios Lallas, Athanassios Kyrgidis, Gerardo Ferrara, Caterina Longo, Massimiliano Scalvenzi, Stefania Staibano, Cristina Carrera, M Alba Díaz, Paolo Broganelli, Carlo Tomasini, Stefano Cavicchini, Raffaele Gianotti, Susana Puig, Josep Malvehy, Pedro Zaballos, Giovanni Pellacani, Giuseppe Argenziano
BACKGROUND: Few studies have described the clinical and dermoscopic features of atypical Spitz tumors. OBJECTIVE: We sought to describe the clinical and dermoscopic features of a series of atypical Spitz tumors as compared with those of conventional Spitz nevi. METHODS: This was a multicenter, retrospective, case-control study, analyzing the clinical and dermoscopic characteristics of 55 atypical Spitz tumors and 110 Spitz nevi that were excised and diagnosed histopathologically...
November 2015: Journal of the American Academy of Dermatology
Amanda Filiberto, Christine Fuller, Jennifer Rhodes
A case of atypical ("pagetoid") compound Spitz nevus on the face of a 2-year-old girl is reported with a review of the literature. The nevus was composed of broad but laterally demarcated compound proliferation of enlarged fusiform and epithelioid melanocytes, with florid pagetoid scatter above the junction. Immunohistochemical analyses revealed the Ki-67 proliferation index to be relatively low. Given the histomorphological overlap with melanoma, an array-based comparative genomic hybridization approach revealed a subthreshold gain in chromosome 1q and gain in distal chromosome 17q, with no other associated chromosomal gains or losses...
2015: Eplasty
Kelly L Harms, Lori Lowe, Douglas R Fullen, Paul W Harms
Spitzoid melanocytic lesions encompass a spectrum from benign Spitz nevi to malignant spitzoid melanomas. Spitzoid melanocytic neoplasms have significant morphologic and molecular differences from conventional melanocytic lesions, and prediction of biologic behavior and metastatic risk may be difficult. Most challenging is the atypical Spitz tumor, a borderline spitzoid melanocytic lesion of uncertain malignant potential that has overlapping histologic features with conventional Spitz nevus and spitzoid melanoma...
October 2015: Archives of Pathology & Laboratory Medicine
Mi Ryung Roh, Philip Eliades, Sameer Gupta, Hensin Tsao
Melanocytic nevi are a benign clonal proliferation of cells expressing the melanocytic phenotype, with heterogeneous clinical and molecular characteristics. In this review, we discuss the genetics of nevi by salient nevi subtypes: congenital melanocytic nevi, acquired melanocytic nevi, blue nevi, and Spitz nevi. While the molecular etiology of nevi has been less thoroughly studied than melanoma, it is clear that nevi and melanoma share common driver mutations. Acquired melanocytic nevi harbor oncogenic mutations in BRAF, which is the predominant oncogene associated with melanoma...
November 2015: Pigment Cell & Melanoma Research
Seungjae Lee, Raymond L Barnhill, Reinhard Dummer, James Dalton, Jianrong Wu, Alberto Pappo, Armita Bahrami
Spitzoid neoplasms constitute a morphologically distinct category of melanocytic tumors, encompassing Spitz nevus (benign), atypical Spitz tumor (intermediate malignant potential), and spitzoid melanoma (fully malignant). Currently, no reliable histopathological criteria or molecular marker is known to distinguish borderline from overtly malignant neoplasms. Because TERT promoter (TERT-p) mutations are common in inherently aggressive cutaneous conventional melanoma, we sought to evaluate their prognostic significance in spitzoid neoplasms...
2015: Scientific Reports
Celia Requena, Virginia Sanz, Eduardo Nagore, Zaida García-Casado, Luis Rubio, Carlos Guillén, Heinz Kutzner
Atypical Spitz tumor with loss of BAP1 or Wiesner nevus is a peculiar variant of intradermal spitzoid melanocytic neoplasm composed of epithelioid melanocytes with a sheet-like growth pattern, abundant infiltrating lymphocytes and rare or absent mitotic activity. This subset of atypical spitzoid tumors is characterized by the BRAF(V600E) mutation and loss of BAP1 expression. Recognition of these lesions is important because they can be a marker for a hereditary BAP1-associated cancer syndrome. We present an unusual case of sporadic Wiesner nevus that had typical histopathologic features and a BAP1 but not a BRAF mutation...
August 2015: Journal of Cutaneous Pathology
Franco Rongioletti, Antonio Guadagno, Caterina Campisi, Francesco Cabiddu, Heinz Kutzner, Aurora Parodi, Roberto Fiocca
The plaque-type blue nevus (PTBN) is a rare variant of blue nevus, of which only a few reports are described. A nodular growth within a preexistent PTBN should always alert to the possibility of malignant transformation. The authors report the first case of an atypical Spitz tumor arising on a congenital linear PTBN in a 60-year-old woman. The diagnosis of "atypical Spitz tumor" is here used to describe a microscopic "gray zone" in which it is not possible to differentiate with adequate certainty between a Spitz nevus and a spitzoid melanoma...
December 2015: American Journal of Dermatopathology
Emi Dika, Pier Alessandro Fanti, Michelangelo Fiorentino, Elisa Capizzi, Iria Neri, Bianca Maria Piraccini, Giulia Maria Ravaioli, Cosimo Misciali, Beatrice Passarini, Annalisa Patrizi
Spitzoid neoplasms may represent a difficult diagnosis in the practice of dermatopathology. We evaluated the concordance of the fluorescence in-situ hybridization (FISH) assay, histopathology, and dermoscopy in a group of adults and in a group of children with spitzoid neoplasms. The FISH assay, designed to detect the copy number of the RREB1 (6p25), MYB (6q23), and CCND1 (11q13) genes and of centromere 6 (Cep 6), was performed in a group of children and in a group of adults with a histopathologic diagnosis of spitzoid neoplasms...
August 2015: Melanoma Research
Miriam Byrne, Padraic J Regan, John L Kelly, Alan Hussey
BACKGROUND: Distinguishing Spitz naevi from malignant melanoma can pose diagnostic dilemmas and atypical subtypes present particular challenges to both clinicians and pathologists. OBJECTIVES: We aimed to review our institutional experience of Spitz naevi, to characterise demographics and analyse the clinical and histological features associated with difficult/equivocal diagnosis of such lesions. Additionally we evaluated discordant cases following expert opinion at a second institution...
April 2015: European Journal of Dermatology: EJD
Masakazu Fujimoto, Juliana L Basko-Plluska, Thomas Krausz, Maria Angelica Selim, Christopher R Shea
Dermal melanophages are frequently encountered in both benign melanocytic nevi and malignant melanoma. In contrast, intraepidermal melanophages (IEM) are under-recognized in melanocytic lesions and their biologic significance is not understood. Herein, we report the clinical and histopathologic features of five melanocytic lesions featuring IEM encountered prospectively in our dermatopathology practice at the University of Chicago. Two hundred and thirty-one (231) archived skin primary melanocytic proliferations were also investigated retrospectively in a de-identified, archival teaching set collection...
June 2015: Journal of Cutaneous Pathology
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