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Chromosomal Aberrations by 4-Color Fluorescence In Situ Hybridization Not Detected in Spitz Nevi of Older Individuals

Basil A. Horst, MD, DrMed; Yuqiang Fang, MD; David N. Silvers, MD; Klaus J. Busam, MD
Arch Dermatol. 2012;148(10):1152-1156. doi:10.1001/archdermatol.2012.2267.
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Objective  To investigate whether Spitz nevi with typical histopathological features in older patients demonstrate chromosomal aberrations by 4-color fluorescence in situ hybridization (FISH).

Design  Retrospective medical record review, with prospective masked histopathological and cytogenetic analyses.

Setting  University-affiliated dermatology and dermatopathology setting.

Patients  Twenty-five patients 50 years or older with melanocytic nevi showing histopathological features typical of Spitz nevi.

Main Outcome Measures  Three dermatopathologists masked to the patients' ages reviewed histopathological sections of melanocytic lesions for features typical of Spitz nevi. FISH was performed on samples with typical histopathological features by a 4-color FISH probe set used for the evaluation of malignant melanocytic neoplasms.

Results  None of the study cases showing histopathological features typical of Spitz nevi had detectable chromosomal abnormalities by FISH.

Conclusions  Spitz nevi in older patients demonstrate molecular features similar to those of Spitz nevi in younger age groups. The findings of normal karyotypes in combination with typical histopathological features are reassuring of Spitz nevus diagnoses in older patients and suggest no correlation of increased malignant potential with advanced age per se.

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Figures

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Grahic Jump Location

Figure 1. Spitz nevus occurring on the thigh of a 57-year-old woman. A, Note epidermal hyperplasia, circumscribed symmetric proliferation of nests, and fascicles of melanocytes (hematoxylin-eosin composite, original magnification ×40). B, Nests of epithelioid melanocytes and Kamino bodies (arrow) (hematoxylin-eosin, original magnification ×100). C, Fluorescence in situ hybridization showing representative nuclei with normal (diploid) karyotype for all 4 chromosomal loci tested. Green indicates CCND1; red, RREB1; gold, MYB; and aqua, CEP6 (original magnification ×630).

Place holder to copy figure label and caption
Grahic Jump Location

Figure 2. Spitz nevus from the leg of a 44-year-old woman showing balanced gains in all 4 probes analyzed. A, Typical histopathological features (hematoxylin-eosin composite, original magnification ×40). B, Nests of epithelioid melanocytes with clefting (hematoxylin-eosin, original magnification ×100). C, Fluorescence in situ hybridization showing representative nuclei with 3 to 4 signals per probe (original magnification ×630).

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