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Fluorescence In Situ Hybridization Analysis of Atypical Melanocytic Proliferations and Melanoma in Young Patients
Author(s) -
DeMarchis Emilia H.,
Swetter Susan M.,
Jennings Charay D.,
Kim Jinah
Publication year - 2014
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12382
Subject(s) - melanoma , medicine , fluorescence in situ hybridization , pathology , fish <actinopterygii> , dermatology , melanocytic nevus , spitz nevus , nevus , biology , cancer research , chromosome , biochemistry , fishery , gene
Abstract Morphologic heterogeneity among melanocytic proliferations is a common challenge in the diagnosis of melanoma. In particular, atypical melanocytic lesions in children, adolescents, and young adults may be difficult to classify because of significant morphologic overlap with melanoma. Recently a four‐probe fluorescence in situ hybridization ( FISH ) protocol to detect chromosomal abnormalities in chromosomes 6 and 11 has shown promise for improving the classification of melanocytic lesions. We sought to determine the correlation between FISH results, morphology, and clinical outcomes in a series of challenging melanocytic proliferations in young patients. We retrospectively performed the standard four‐probe FISH analysis on 21 melanocytic neoplasms from 21 patients younger than 25 years of age (range 5–25 years, mean 14.6 years) from Stanford University Medical Center who were prospectively followed for a median of 51 months (range 1–136 months). The study cohort included patients with 5 confirmed melanomas, 2 melanocytic tumors of uncertain malignant potential (Mel TUMP s), 10 morphologically challenging atypical Spitz tumors ( AST s), and 4 typical Spitz nevi. FISH detected chromosomal aberrations in all five melanomas and in one Mel TUMP , in which the patient developed subsequent lymph node and distant metastasis. All 10 AST s, 4 Spitz nevi, and 1 of 2 Mel TUMP s were negative for significant gains or losses in chromosomes 6 and 11q. Our findings demonstrated a strong correlation between positive FISH results and the histomorphologic impression of melanoma. This finding was also true for the Mel TUMP with poor clinical outcome. Therefore FISH may serve as a helpful adjunct in the classification of controversial melanocytic tumors in young patients.