PRAME expression correlates with genomic aberration and malignant diagnosis of spitzoid melanocytic neoplasms Journal Article


Authors: Gerami, P.; Benton, S.; Zhao, J.; Zhang, B.; Lampley, N. 3rd; Roth, A.; Boutko, A.; Olivares, S.; Busam, K. J.
Article Title: PRAME expression correlates with genomic aberration and malignant diagnosis of spitzoid melanocytic neoplasms
Abstract: ABSTRACT: Spitzoid melanocytic neoplasms are a diagnostically challenging class of lesions in dermatopathology. Recently, molecular assays and immunohistochemical markers have been explored as ancillary methods to assist in the diagnostic workup. Specifically, preferentially expressed antigen in melanoma (PRAME) immunohistochemistry is a nuclear stain commonly positive in melanomas, but not in nevi. This study investigates PRAME immunoreactivity (≥75% positive nuclear staining in tumor cells) in a set of 59 spitzoid melanocytic neoplasms with known clinical outcomes. We compared PRAME status with (1) the clinical outcomes, (2) the morphologic diagnoses, and (3) the status of TERT promoter mutation. Regarding clinical outcomes, 3 cases developed metastatic disease, of which 2 expressed diffusely positive PRAME staining. Of the 56 cases that did not show evidence of metastasis, 6 expressed diffusely positive PRAME staining. Morphologically, diffusely positive PRAME staining was seen in 7 of 21 cases (33.3%) diagnosed as melanoma and only 1 benign tumor 1 of 38 (2.6%). There were 4 of 8 cases with a TERT promoter mutation which were diffusely PRAME-positive compared with 4 of 51 cases without TERT promoter mutation ( P = 0.001). Our results show a statistically significant correlation between PRAME expression and the diagnosis, outcome, and TERT promoter mutation status of atypical spitzoid melanocytic neoplasms, suggesting immunohistochemistry for PRAME can help support a suspected diagnosis. However, because of occasional false-positive and negative test results, correlation with the clinical and histologic findings as well as results from other tests is needed for the interpretation of diagnostically challenging spitzoid melanocytic neoplasms. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: immunohistochemistry; genetics; melanoma; nevus; skin neoplasms; diagnosis, differential; differential diagnosis; pathology; tumor antigen; tumor marker; skin tumor; antigens, neoplasm; genomics; nevus, epithelioid and spindle cell; humans; human; biomarkers, tumor; prame protein, human
Journal Title: American Journal of Dermatopathology
Volume: 44
Issue: 8
ISSN: 0193-1091
Publisher: Lippincott Williams & Wilkins  
Date Published: 2022-08-01
Start Page: 575
End Page: 580
Language: English
DOI: 10.1097/dad.0000000000002208
PUBMED: 35503885
PROVIDER: scopus
PMCID: PMC11010723
DOI/URL:
Notes: Article -- Export Date: 1 August 2022 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Klaus J Busam
    688 Busam