title: The impact of molecular morphology techniques on the expert diagnosis in melanocytic skin neoplasms.
abstract: Thirteen melanocytic skin neoplasms with a consultation diagnosis by A. Bernard Ackerman were submitted to immunohistochemistry for HMB-45, Ki67, cyclin D1, e-cadherin, and p16; 9/13 cases underwent fluorescence in situ hybridization (FISH) test targeting 6p25 (RREB1), 6q23 (MYB), centromere 6 (Cep6), and 11q13 (CCND1), as well as the centromere 7 (Cep7). A "consensus diagnosis" among 3 experts was also advocated both before and after morphomolecular information. Three neoplasms with a consultation diagnosis of Spitz nevus showed at least 3 abnormal immunohistochemical patterns; 2 of these cases were also FISH-positive for CCND1 gain, but none of them had a final consensus diagnosis of melanoma. Two neoplasms with a consultation diagnosis of congenital nevus received a consensus diagnosis of melanoma. Molecular morphology techniques can highlight the atypical features of melanocytic neoplasms and support existence of a morphobiologic "spectrum": This should be mirrored in the final report by abandoning the dichotomic (benign vs malignant) diagnostic approach.
authors.affiliation: 1Gaetano Rummo General Hospital, Benevento, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Cosimo
authors.initials: C
authors.lastname: Misciali
authors.forename: Thomas
authors.initials: T
authors.lastname: Brenn
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
authors.forename: Dmitry W
authors.initials: DW
authors.lastname: Kazakov
authors.forename: Antonio
authors.initials: A
authors.lastname: Perasole
authors.forename: Rosa
authors.initials: R
authors.lastname: Russo
authors.forename: Roberto
authors.initials: R
authors.lastname: Ricci
authors.forename: Giuliana
authors.initials: G
authors.lastname: Crisman
authors.forename: Pier Alessandro
authors.initials: PA
authors.lastname: Fanti
authors.forename: Beatrice
authors.initials: B
authors.lastname: Passarini
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor
keywords: atypical nevus; fluorescence in situ hybridization; immunohistochemistry; melanoma