Immunohistochemical and molecular analysis of spitzoid neoplasms with pulverocyte subclones

Clinical and Experimental Dermatology
Sapna M AminPedram Gerami

Abstract

Clonal naevi are characterized by a focal proliferation of pigmented melanocytes in an otherwise banal naevus. These subclones are often composed of aggregates of larger, epithelioid melanocytes with nuclear atypia and dusty-grey cytoplasmic pigmentation, which are referred to as 'pulverocytes', and this finding may lead to a misdiagnosis of malignant melanoma (MM). To characterize the significance of subclones of dusty-grey pigmented epithelioid melanocytes within spitzoid neoplasms. We studied the histological and molecular features of a series of 20 spitzoid neoplasms with pulverocyte subclones encountered in our practice, including both atypical Spitz tumours (ASTs) and invasive MMs. Pulverocytes were predominantly dermal, and the percentage of subclones ranged from 2% to 40%, with a median of 10% in ASTs and 25% in lesions we classified as MM. In cases with > 10% subclones, there was an increased odds of fluorescence in situ hybridization positivity (OR = 12; 95% CI 1.2-293.4; P = 0.03) and an increased odds of homozygous 9p21 deletion (OR = 3.6; 95 CI 0.28-89.82; P = 0.33), although the latter did not reach statistical significance. We consider spitzoid lesions with a small subclone population to be a variant of a clonal ...Continue Reading

References

May 1, 1994·Journal of the American Academy of Dermatology·N J Ball, L E Golitz
Oct 1, 1993·The American Journal of Dermatopathology·P Milde, A B Ackerman
Jun 30, 2009·The American Journal of Surgical Pathology·Pedram GeramiBoris C Bastian
Aug 13, 2011·The American Journal of Surgical Pathology·Pedram PouryazdanparastPedram Gerami
May 17, 2012·The American Journal of Surgical Pathology·Pedram GeramiKaterina Pestova

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