Expanding the spectrum of microscopic and cytogenetic findings associated with Spitz tumors with 11p gains Journal Article


Authors: Lezcano, C. M.; Yeh, I.; Eslamdoost, N.; Fang, Y.; Leboit, P. E.; McCalmont, T. H.; Moy, A. P.; Zhang, Y.; Busam, K. J.
Article Title: Expanding the spectrum of microscopic and cytogenetic findings associated with Spitz tumors with 11p gains
Abstract: A subset of Spitz tumors is associated with a copy number increase of chromosome 11p and activating mutations of HRAS. These aberrations have been reported to occur in association with desmoplastic Spitz nevi. Little is known to what extent 11p gains can also be found in nondesmoplastic tumors. To learn more about the spectrum of microscopic and cytogenetic changes that can be seen in Spitz lesions in association with 11p gains, we reviewed the clinical and pathologic features of 40 cases. Patient ages ranged from 3 to 75 years. The most common anatomic site was the head and neck region, followed by the upper extremities. Prominent desmoplasia was present in 10 cases. Seven tumors lacked significant stromal fibrosis. Twenty tumors were mitotically active. Novel microscopic features encountered in a few cases include a tumor with a polypoid silhouette and papillomatous surface and rare atypical tumors with a deep bulbous growth pattern. Among 36 cases analyzed by single-nucleotide polymorphism array or comparative genomic hybridization, 28 tumors had gains of the entire or near-entire p-arm of chromosome 11 with no other coexisting unbalanced genomic aberration. Eight cases had additional changes; 6 of these with 1 additional aberration per case, and 2 cases had several chromosomal aberrations. We also examined a subset of tumors by fluorescence in situ hybridization for the HRAS gene locus (11p15.5). All tumors were fluorescence in situ hybridization-positive. In conclusion, we expand the spectrum of pathologic findings associated with Spitz tumors with 11p gains. This cytogenetic aberration is not restricted to desmoplastic Spitz nevi. It can also be seen in nondesmoplastic and papillomatous lesions and atypical melanocytic tumors with a deep bulbous growth. We also document that in some Spitz tumors additional cytogenetic aberrations may be found, the significance of which remains to be determined. © 2021 Lippincott Williams and Wilkins. All rights reserved.
Keywords: melanoma; spitz nevus; hras; atypical spitz tumor; spitzoid; 11p
Journal Title: American Journal of Surgical Pathology
Volume: 45
Issue: 2
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2021-02-01
Start Page: 277
End Page: 285
Language: English
DOI: 10.1097/pas.0000000000001607
PUBMED: 33428338
PROVIDER: scopus
PMCID: PMC7808272
DOI/URL:
Notes: Article -- Export Date: 1 March 2021 -- Source: Scopus
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  1. Klaus J Busam
    690 Busam
  2. Yuqiang Fang
    23 Fang
  3. Yanming Zhang
    203 Zhang
  4. Andrea Primiani Moy
    32 Moy