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      Use of fluorescence in situ hybridization (FISH) to distinguish intranodal nevus from metastatic melanoma.

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          Abstract

          With the increase in sentinel lymph node biopsies in melanoma patients, pathologists are frequently confronted with small deposits of morphologically bland melanocytes in the node, which occasionally cannot be readily classified as benign nodal nevi or melanoma. As most melanomas harbor characteristic chromosomal aberrations which can be used to distinguish them from benign nevi, we used fluorescence in-situ hybridization (FISH) with markers for 3 regions on chromosome 6 and 1 on chromosome 11 to determine the presence of chromosomal aberrations in sentinel lymph node specimens with small foci of melanocytes that had been diagnosed as metastatic melanoma or nodal nevi by histopathology. Fifty-nine tissue samples from 41 patients (24 lymph node metastases, 17 with nodal nevi, and 18 of the available corresponding primary melanomas) were analyzed by FISH. Twenty of 24 (83%) cases diagnosed as metastatic melanoma showed aberrations by FISH. Of the 4 negative cases, 3 were unequivocal melanoma metastases, whereas 1 on re-review was histopathologically equivocal. Of the 17 nodal nevi, 1 (6%) also showed aberrations by FISH, whereas the remainder was negative. Multiple aberrations were present in the positive case, some of which were also found in the corresponding primary tumor, suggesting that this case represents a deceptively bland melanoma metastasis that had been misclassified by histomorphology. Our data indicate that FISH is a useful adjunct tool to traditional methods in the diagnostic workup of deposits of melanocytes in lymph nodes that are histopathologically ambiguous.

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          Author and article information

          Journal
          Am. J. Surg. Pathol.
          The American journal of surgical pathology
          Ovid Technologies (Wolters Kluwer Health)
          1532-0979
          0147-5185
          Feb 2010
          : 34
          : 2
          Affiliations
          [1 ] Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX, USA.
          Article
          NIHMS175443
          10.1097/PAS.0b013e3181c805c4
          2831773
          20087158
          1ddd3bd6-3469-4134-92d2-8e2758a86798
          History

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