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Gerami P, Chen A, Sharma N, Patel P, Hagstrom M, Kancherla P, Geraminejad T, Olivares S, Biswas A, Bosenberg M, Busam KJ, de La Fouchardière A, Duncan LM, Elder DE, Ko J, Landman G, Lazar AJ, Lowe L, Massi D, Mihic-Probst D, Parker DC, Scolyer RA, Shea CR, Zembowicz A, Yun SJ, Blokx WAM, Barnhill RL. BRAF Mutated and Morphologically Spitzoid Tumors, a Subgroup of Melanocytic Neoplasms Difficult to Distinguish From True Spitz Neoplasms. Am J Surg Pathol 2024; 48:538-545. [PMID: 38525831 DOI: 10.1097/pas.0000000000002194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Drivers of Spitz neoplasms include activating point mutations in HRAS and Spitz-associated genomic fusions. It has become evident that some BRAF -mutated melanocytic neoplasms can morphologically mimic Spitz tumors (STs). These have been termed BRAF mutated and morphologically spitzoid (BAMS). In this study, 17 experts from the International Melanoma Pathology Study Group assessed 54 cases which included 40 BAMS and 14 true STs. The participants reviewed the cases blinded to the genomic data and selected among several diagnostic options, including BAMS, ST, melanoma, and other. A total of 38% of all diagnostic selections in the BAMS cases were for BAMS, whereas 32% were for ST. In 22 of the BAMS cases, the favored diagnosis was BAMS, whereas in 17 of the BAMS cases, the favored diagnosis was ST. Among the 20 cases in the total group of 54 with the highest number of votes for ST, half were BAMS. Of BAMS, 75% had a number of votes for ST that was within the SD of votes for ST seen among true ST cases. There was poor interobserver agreement for the precise diagnosis of the BAMS (kappa = 0.16) but good agreement that these cases were not melanoma (kappa = 0.7). BAMS nevi/tumors can closely mimic Spitz neoplasms. Expert melanoma pathologists in this study favored a diagnosis of ST in nearly half of the BAMS cases. There are BAMS cases that even experts cannot morphologically distinguish from true Spitz neoplasms.
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Affiliation(s)
- Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Alice Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Natasha Sharma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Pragi Patel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Pranav Kancherla
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Tara Geraminejad
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University
| | - Asok Biswas
- Department of Pathology, Western General Hospital, Edinburgh, UK
| | | | - Klaus J Busam
- Department of Pathology, Dermatopathology Service, Memorial Sloan Kettering Cancer Center, New York City, NY
| | | | - Lyn M Duncan
- Department of Dermatopathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Jennifer Ko
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH
| | - Gilles Landman
- Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Alexander J Lazar
- Department of Pathology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Lori Lowe
- Department of Dermatology and Pathology, University of Michigan Medical School, Ann Arbor, MI
| | - Daniela Massi
- Department of Health Sciences, Section of Anatomic Pathology, University of Florence, Florence, Italy
| | - Daniela Mihic-Probst
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Douglas C Parker
- Departments of Pathology and Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Richard A Scolyer
- Department of Tissue Pathology, Royal Prince Alfred Hospital, and NSW Health Pathology, North Sydney, NSW, Australia
- Department of Dermatopathology, The University of Sydney, Sydney, NSW, Australia
- Melanoma Institute Australia, North Sydney, NSW, Australia
| | - Christopher R Shea
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
| | - Artur Zembowicz
- Department of Anatomic and Clinical Pathology, Tufts Medical School, Boston, MA
| | - Sook Jung Yun
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Willeke A M Blokx
- Department of Pathology, Division Laboratories, Pharmacy and Biomedical Genetics University Medical Center Utrecht, The Netherlands
| | - Raymond L Barnhill
- Department of Translational Research, Curie Institute, Paris Sciences & Letters University, and UFR of Medicine, University of Paris Cité, Paris, France
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Patel P, Hagstrom M, Sharma N, Chen A, Dhillon S, Fumero-Velázquez M, Olivares S, Gerami P. Clinical, Morphologic, and Molecular Features of MAP3K8 Rearranged Spitz Neoplasms: A Retrospective Study Documenting That Bonafide Spitz Melanomas Are Rare. Am J Surg Pathol 2024; 48:437-446. [PMID: 38233731 DOI: 10.1097/pas.0000000000002179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Previous studies regarding the clinical behavior of Spitz neoplasms lack genomic characterization. We aim to assess our hypothesis that most MAP3K8 Spitz neoplasms are indolent despite MAP3K8 being the single most common driver of Spitz melanoma. Further, we aim to identify genomic features associated with aggressive behavior and to better characterize the morphology of these cases. We analyzed the outcomes of MAP3K8 Spitz neoplasms. We also performed a meta-analysis of the outcomes of MAP3K8 Spitz from the literature. Morphologic features were compared with other variants of Spitz using a Student t test and χ 2 test. Two of 35 cases resulted in local recurrence and one of these cases had local regional metastasis; all other cases had no evidence of recurrence (mean follow-up time: 33 mo). MAP3K8 Spitz only rarely results in aggressive behavior. Metastatic cases have genomic mutations associated with tumor progression. Morphologically, MAP3K8 Spitz neoplasms frequently showed nodular silhouette, large cell size, epithelioid morphology, and severe nuclear atypia resulting in more frequent diagnosis as Spitz melanoma. Most MAP3K8 Spitz neoplasms have excellent prognoses, apart from rare cases harboring additional genomic abnormalities associated with tumor progression.
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Affiliation(s)
- Pragi Patel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Fumero-Velázquez M, Hagstrom M, Dhillon S, Geraminejad T, Olivares S, Donati M, Nosek D, Waldenbäck P, Kazakov D, Sheffield BS, Tron VA, Gerami P. Clinical, Morphologic, and Molecular Features of Benign and Intermediate-grade Melanocytic Tumors With Activating Mutations in MAP2K1. Am J Surg Pathol 2023; 47:1438-1448. [PMID: 37773074 DOI: 10.1097/pas.0000000000002131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Activating mutations in MAP2K1 can be seen in benign and intermediate-grade melanocytic neoplasms with spitzoid morphology. We analyzed the clinical, histopathologic, and genetic features for 16 cases of benign and intermediate-grade melanocytic tumors harboring activating MAP2K1 mutations. We compared them to Spitz neoplasms with characteristic Spitz fusions or HRAS mutation. We also compared the mutational pattern of benign and intermediate-grade MAP2K1 -mutated neoplasms and melanomas with activating MAP2K1 mutations. Among the 16 cases, the favored morphologic diagnosis was Spitz nevus (8/16), atypical Spitz tumors (6/16), and deep penetrating nevus (2/16). The 2 most common architectural patterns seen included a plaque-like silhouette with fibroplasia around the rete reminiscent of a dysplastic nevus (n=7) or a wedge-shaped or nodular pattern with the plexiform arrangement of the nests aggregating around the adnexa or neurovascular bundle (n=8). The cases with dysplastic architecture and spitzoid cytology resembled dysplastic Spitz nevi. Compared with true Spitz neoplasms, MAP2K1 -mutated neoplasms occurred in older age groups and had more frequent pagetosis and a lower average mitotic count. The most common type of mutation in the benign and intermediate-grade cases in the literature involves an in-frame deletion, while, in melanomas, missense mutations are predominant. Benign and intermediate-grade melanocytic neoplasms with activating mutations in MAP2K1 can have morphologic overlap with Spitz neoplasms. A significant proportion of melanomas also have activating MAP2K1 mutations. In-frame deletions are predominantly seen in the benign and intermediate-grade cases, and missense mutations are predominantly seen in melanomas.
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Affiliation(s)
- Mónica Fumero-Velázquez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Soneet Dhillon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Tara Geraminejad
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Michele Donati
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Daniel Nosek
- Department of Pathology, Umeå University, Umeå, Sweden
| | | | - Dmitry Kazakov
- Institute for Dermatohistopathology, Pathology Institute Enge, Zürich, Switzerland
| | | | - Victor A Tron
- Department of Laboratory Medicine and Pathology, University of Toronto
- Department of Laboratory Medicine, Lifelabs LP, Toronto, ON, Canada
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Hagstrom M, Dhillon S, Fumero-Velázquez M, Olivares S, Gerami P. A reappraisal of the epidemiology of Spitz neoplasms in the molecular era: A retrospective cohort study. J Am Acad Dermatol 2023; 89:1185-1191. [PMID: 37567480 DOI: 10.1016/j.jaad.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Previous studies suggest that Spitz neoplasms occur primarily in younger patients, leading pathologists to shy away from diagnosing a benign Spitz neoplasm in the elderly. With the advent of genomic sequencing, there is a need for reappraisal of the epidemiology of Spitz neoplasms in the modern molecular era. OBJECTIVE We aim to reassess the epidemiology of Spitz neoplasms incorporating next-generation sequencing. METHODS We looked at 53,814 non-Spitz neoplasms and 1260 Spitz neoplasms including 286 Spitz neoplasms with next-generation sequencing testing and collected various epidemiologic data. RESULTS In our general pool of cases, the proportion of Spitz neoplasm cases occurring is relatively the same in each of the first 4 decades of life with a precipitous drop in the fifth decade. In assessing a group of genomically verified cases of Spitz neoplasms, the drop was much less significant and up to 20% of all Spitz neoplasm cases occurred in patients over 50 years of age. LIMITATIONS Limitations included the number of genetically verified Spitz neoplasm cases available and a possible bias as to which cases undergo genomic testing. CONCLUSION Genomic verification may allow more confident diagnosis of Spitz neoplasms in patients over 50 years of age and avoid melanoma overdiagnosis.
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Affiliation(s)
- Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Soneet Dhillon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Mónica Fumero-Velázquez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
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Hagstrom M, Kabbur G, Schultz B, Bigliardi P, Giubellino A. Immune Checkpoint Inhibitor-Induced Lichen Planus Pemphigoides: Report of Two Cases. Dermatitis 2023; 34:557-559. [PMID: 36716176 DOI: 10.1089/derm.2022.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
| | - Gowri Kabbur
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - Brittney Schultz
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - Paul Bigliardi
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
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Fumero-Velázquez M, Hagstrom M, Dhillon S, Olivares S, Jennings LJ, Dittman D, Sukhanova M, Arva NC, Goldstein SD, Theos A, Pavlidakey P, Carr Z, Gerami P. Agminated presentation of fusion-driven melanocytic neoplasms. J Cutan Pathol 2023; 50:913-921. [PMID: 37407520 DOI: 10.1111/cup.14482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/09/2023] [Accepted: 05/31/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND The conventionally understood pathogenesis of agminated Spitz nevi includes a mosaic HRAS mutation followed by copy number gains in 11p. However, we have recently observed agminated presentations of fusion-driven melanocytic neoplasms. METHODS We retrieved cases from our database of benign fusion-induced melanocytic neoplasms with an agminated presentation. Both the primary lesion and the secondary lesion were sequenced. TERT-promoter mutational testing and the melanoma fluorescence in situ hybridization assay were also performed. RESULTS Three cases were included. Two had a PRKCA fusion (partners ATP2B4 and MPZL1) and one had a ZCCHC8::ROS1 fusion. None of the cases met morphologic or molecular criteria for malignancy. There was no evidence of tumor progression in secondary lesions. The same fusion was identified in the primary and secondary lesions. None of the patients developed evidence of nodal or systemic metastasis. CONCLUSIONS We present accumulating evidence that fusion-driven melanocytic neoplasms can present with an agminated presentation. The differential diagnosis of an agminated presentation versus a locally recurrent or potentially locally metastatic tumor is critical, and accurate diagnosis has significant prognostic and therapeutic consequences for the patient. As with HRAS mutations, fusion-driven melanocytic tumors may have an agminated presentation.
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Affiliation(s)
- Mónica Fumero-Velázquez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Soneet Dhillon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Lawrence J Jennings
- Division of Molecular Pathology, Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - David Dittman
- Division of Molecular Pathology, Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Madina Sukhanova
- Division of Molecular Pathology, Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Nicoleta C Arva
- Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois, USA
| | - Seth D Goldstein
- Department of Surgery, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Amy Theos
- Department of Dermatology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Peter Pavlidakey
- Department of Dermatology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Zachary Carr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Boutko A, Hagstrom M, Lampley N, Roth A, Olivares S, Dhillon S, Fumero-Velázquez M, Benton S, Zhao J, Zhang B, Dittmann D, Asadbeigi S, Busam KJ, Gerami P. PRAME Immunohistochemical Expression and TERT Promoter Mutational Analysis as Ancillary Diagnostic Tools for Differentiating Proliferative Nodules From Melanoma Arising in Congenital Nevi. Am J Dermatopathol 2023; 45:437-447. [PMID: 37338065 DOI: 10.1097/dad.0000000000002357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
ABSTRACT Proliferative nodules (PNs) are benign melanocytic proliferations that typically develop within congenital melanocytic nevi. These tumors have overlapping histological features with melanoma. Ancillary immunohistochemistry and genomic sequencing are often used in diagnostically challenging cases. To assess the utility of preferentially expressed antigen in melanoma (PRAME) immunoreactivity and telomerase reverse transcriptase (TERT) promoter mutation analysis in distinguishing PNs from melanoma arising in congenital nevi cases. Twenty-one PNs and 2 melanomas arising in congenital nevi were immunohistochemically stained with PRAME. Cases with adequate tissue were also assessed for TERT promoter mutations through sequencing studies. The positivity rates in the PN cases were compared with those of the melanomas. Two of 21 PN cases were diffusely positive for PRAME (≥75% of the tumor cells positive). Two of 2 melanomas arising in congenital nevus cases were also diffusely PRAME positive. The difference was statistically significant using a Fisher exact test. None of the tumors harbored TERT promoter mutations. PRAME immunohistochemical marker may have diagnostic value in distinguishing diagnostically challenging PNs from melanoma, but diffuse expression is not specific for melanoma.
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Affiliation(s)
- Anastasiya Boutko
- Research Fellow, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Michael Hagstrom
- Research Fellow, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Nathaniel Lampley
- Research Fellow, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Andrew Roth
- Research Fellow, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Shantel Olivares
- Research Technologist, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Soneet Dhillon
- Research Technologist, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Mónica Fumero-Velázquez
- Research Technologist, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sarah Benton
- Research Technologist, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Jeffrey Zhao
- Research Technologist, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Bin Zhang
- Research Technologist, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - David Dittmann
- Developmental Coordinator, Department of Molecular Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sepideh Asadbeigi
- Dermatopathology Fellow, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Klaus J Busam
- Director of Dermatopathology, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - Pedram Gerami
- Professor of Dermatology and Pathology, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Roth A, Boutko A, Lampley N, Dhillon S, Hagstrom M, Olivares S, Dittman D, Jennings L, Santana Dos Santos L, Busam K, Gerami P. Next-generation Sequencing as a Potential Diagnostic Adjunct in Distinguishing Between Desmoplastic Melanocytic Neoplasms. Am J Surg Pathol 2023; 47:318-325. [PMID: 36383901 DOI: 10.1097/pas.0000000000001999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Desmoplastic melanomas (DMs) are often challenging to diagnose and ancillary tests, such as immunohistochemistry, have limitations. One challenge is distinguishing DM from benign desmoplastic melanocytic neoplasms. In this study, we explored the utility of next-generation sequencing data in the diagnosis of DMs versus desmoplastic Spitz nevi (DSN) and desmoplastic nevi (DN). We sequenced 47 cases and retrieved 12 additional previously sequenced clinical cases from our dermatopathology database. The 59 total cases were comprised of 21 DMs, 25 DSN, and 13 DN. The DMs had the highest tumor mutation burden at 22 mutations/megabase (m/Mb) versus the DSN (6 m/Mb) and DN (8 m/Mb). Truncating mutations in NF1 resulting in a loss-of-function were exclusive to the DM cohort, identified in 8/21 (38%) cases. Importantly, missense mutations in NF1 were nonspecific and seen with similar frequency in the different cohorts. Other mutations exclusive to the DMs included truncating mutations in TP53 , CDKN2A , and ARID2 . Among the DSN, 17/25 (68%) had an HRAS mutation or receptor tyrosine kinase fusion consistent with other Spitz tumors. Two cases in the DN cohort had missense mutations in BRAF without additional progression mutations and 2 other cases had mutations in GNAQ , supporting a diagnosis of a sclerosing blue nevus. The remainder of the DN had nonspecific mutations in various signaling pathways with few progression mutations. Overall, our study provides preliminary data that next-generation sequencing data may have the potential to serve as an ancillary diagnostic tool to help differentiate malignant and benign desmoplastic melanocytic neoplasms.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Klaus Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Pedram Gerami
- Departments of Dermatology
- Robert H. Lurie Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Hagstrom M, Fumero-Velázquez M, Dhillon S, Olivares S, Gerami P. An update on genomic aberrations in Spitz naevi and tumours. Pathology 2023; 55:196-205. [PMID: 36631338 DOI: 10.1016/j.pathol.2022.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
Spitz neoplasms continue to be a diagnostic challenge for dermatopathologists and are defined by distinctive morphological and genetic features. With the recent advancements in genomic sequencing, the classification, diagnosis, and prognostication of these tumours have greatly improved. Several subtypes of Spitz neoplasms have been identified based on their specific genomic aberrations, which often correlate with distinctive morphologies and biological behaviour. These genetic driver events can be classified into four major groups, including: (1) mutations [HRAS mutations (with or without 11p amplification) and 6q23 deletions]; (2) tyrosine kinase fusions (ROS1, ALK, NTRK1-3, MET and RET); (3) serine/threonine kinase fusions and mutations (BRAF, MAP3K8, and MAP2K1); and (4) other rare genomic aberrations. These driver genomic events are hypothesised to enable the initial proliferation of melanocytes and are often accompanied by additional genomic aberrations that affect biological behaviour. The discovery of theses genomic fusions has allowed for a more objective definition of a Spitz neoplasm. Further studies have shown that the majority of morphologically Spitzoid appearing melanocytic neoplasms with aggressive behaviour are in fact BRAF or NRAS mutated tumours mimicking Spitz. Truly malignant fusion driven Spitz neoplasms may occur but are relatively uncommon, and biomarkers such as homozygous 9p21 (CDKN2A) deletions or TERT-p mutations can have some prognostic value in such cases. In this review, we discuss the importance and various methods of identifying Spitz associated genomic fusions to help provide more definitive classification. We also discuss characteristic features of the various fusion subtypes as well as prognostic biomarkers.
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Affiliation(s)
- Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mónica Fumero-Velázquez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Soneet Dhillon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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10
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Luessen DJ, Sun H, McGinnis MM, Hagstrom M, Marrs G, McCool BA, Chen R. Acute ethanol exposure reduces serotonin receptor 1A internalization by increasing ubiquitination and degradation of β-arrestin2. J Biol Chem 2019; 294:14068-14080. [PMID: 31366729 DOI: 10.1074/jbc.ra118.006583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 07/23/2019] [Indexed: 11/06/2022] Open
Abstract
Acute alcohol exposure alters the trafficking and function of many G-protein-coupled receptors (GPCRs) that are associated with aberrant behavioral responses to alcohol. However, the molecular mechanisms underlying alcohol-induced changes in GPCR function remain unclear. β-Arrestin is a key player involved in the regulation of GPCR internalization and thus controls the magnitude and duration of GPCR signaling. Although β-arrestin levels are influenced by various drugs of abuse, the effect of alcohol exposure on β-arrestin expression and β-arrestin-mediated GPCR trafficking is poorly understood. Here, we found that acute ethanol exposure increases β-arrestin2 degradation via its increased ubiquitination in neuroblastoma-2a (N2A) cells and rat prefrontal cortex (PFC). β-Arrestin2 ubiquitination was likely mediated by the E3 ligase MDM2 homolog (MDM2), indicated by an increased coupling between β-arrestin2 and MDM2 in response to acute ethanol exposure in both N2A cells and rat PFC homogenates. Importantly, ethanol-induced β-arrestin2 reduction was reversed by siRNA-mediated MDM2 knockdown or proteasome inhibition in N2A cells, suggesting β-arrestin2 degradation is mediated by MDM2 through the proteasomal pathway. Using serotonin 5-HT1A receptors (5-HT1ARs) as a model receptor system, we found that ethanol dose-dependently inhibits 5-HT1AR internalization and that MDM2 knockdown reverses this effect. Moreover, ethanol both reduced β-arrestin2 levels and delayed agonist-induced β-arrestin2 recruitment to the membrane. We conclude that β-arrestin2 dysregulation by ethanol impairs 5-HT1AR trafficking. Our findings reveal a critical molecular mechanism underlying ethanol-induced alterations in GPCR internalization and implicate β-arrestin as a potential player mediating behavioral responses to acute alcohol exposure.
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Affiliation(s)
- Deborah J Luessen
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Haiguo Sun
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Molly M McGinnis
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Michael Hagstrom
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Glen Marrs
- Center for Molecular Signaling, Department of Biology, Wake Forest University, Winston Salem, North Carolina 27106
| | - Brian A McCool
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Rong Chen
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157 .,Center for Molecular Signaling, Department of Biology, Wake Forest University, Winston Salem, North Carolina 27106.,Center for the Neurobiology of Addiction Treatment, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
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Wiley AP, Luessen DJ, Hagstrom M, Sun H, Chen R. RGS2 Modulation of Angiotensin II Receptor Type 1 Trafficking and Signaling in Neuroblastoma Cells. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.669.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aidan P Wiley
- Physiology and PharmacologyWake Forest Univeristy Health SciencesWinston SalemNC
| | - Deborah J Luessen
- Physiology and PharmacologyWake Forest Univeristy Health SciencesWinston SalemNC
| | - Michael Hagstrom
- Physiology and PharmacologyWake Forest Univeristy Health SciencesWinston SalemNC
| | - Haiguo Sun
- Physiology and PharmacologyWake Forest Univeristy Health SciencesWinston SalemNC
| | - Rong Chen
- Physiology and PharmacologyWake Forest Univeristy Health SciencesWinston SalemNC
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