Use of Fluorescence In situ Hybridization (FISH) to Distinguish Intranodal Nevus From Metastatic Melanoma
| Autor: | Boris C. Bastian, Rob Werling, Nicholas A. Kolaitis, Philip E. LeBoit, Maj Scott R Dalton, Pedram Gerami, Susan Charzan |
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| Rok vydání: | 2010 |
| Předmět: |
Pathology
medicine.medical_specialty Skin Neoplasms Sentinel lymph node Biology Article Pathology and Forensic Medicine Metastasis Diagnosis Differential medicine Humans Nevus Melanoma neoplasms Lymph node In Situ Hybridization Fluorescence Chromosome Aberrations Nevus Pigmented medicine.diagnostic_test Cancer medicine.disease Primary tumor medicine.anatomical_structure Lymphatic Metastasis Melanocytes Female Surgery Lymph Nodes Anatomy Fluorescence in situ hybridization |
| Zdroj: | American Journal of Surgical Pathology. 34:231-237 |
| ISSN: | 0147-5185 |
| DOI: | 10.1097/pas.0b013e3181c805c4 |
| Popis: | With the increase in sentinel lymph node biopsies in melanoma patients, pathologists are frequently confronted with small deposits of morphologically bland melanocytes in the node, which occasionally cannot be readily classified as benign nodal nevi or melanoma. As most melanomas harbor characteristic chromosomal aberrations which can be used to distinguish them from benign nevi, we used fluorescence in-situ hybridization (FISH) with markers for 3 regions on chromosome 6 and 1 on chromosome 11 to determine the presence of chromosomal aberrations in sentinel lymph node specimens with small foci of melanocytes that had been diagnosed as metastatic melanoma or nodal nevi by histopathology. Fifty-nine tissue samples from 41 patients (24 lymph node metastases, 17 with nodal nevi, and 18 of the available corresponding primary melanomas) were analyzed by FISH. Twenty of 24 (83%) cases diagnosed as metastatic melanoma showed aberrations by FISH. Of the 4 negative cases, 3 were unequivocal melanoma metastases, whereas 1 on re-review was histopathologically equivocal. Of the 17 nodal nevi, 1 (6%) also showed aberrations by FISH, whereas the remainder was negative. Multiple aberrations were present in the positive case, some of which were also found in the corresponding primary tumor, suggesting that this case represents a deceptively bland melanoma metastasis that had been misclassified by histomorphology. Our data indicate that FISH is a useful adjunct tool to traditional methods in the diagnostic workup of deposits of melanocytes in lymph nodes that are histopathologically ambiguous. |
| Databáze: | OpenAIRE |
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