Rosette‐like structures in the spectrum of spitzoid tumors

Arps, David P.; Harms, Paul W.; Chan, May P.; Fullen, Douglas R.

doi:10.1111/cup.12192

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…The subcapsular and parenchymal involvement of 3 lymph nodes favors a diagnosis of metastatic melanoma. Rosette-like structures with eccentrically located nuclei and centrally aggregated cytoplasm resembling a neural neoplasm, also pointed to melanoma, 42,43 although we found 1 published case of BPN in an adult 11 and 5 cases of Spitz nevus [44][45][46] with these structures. Some authors would rather use the term atypical PN for these cases, 5,47 suggesting that atypical PN are distinct borderline lesions residing between BPN and MM, 47 within a spectrum of melanocytic skin neoplasms.…”

Section: Discussionmentioning

confidence: 75%

Metastatic Melanoma in Association With a Giant Congenital Melanocytic Nevus in an Adult

Machan

Molina-Ruiz

Fernández-Aceñero³

et al. 2015

The American Journal of Dermatopathology

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Giant congenital melanocytic nevi (GCMNs) represent a distress to patients for 2 reasons: one is disfigurement, and the other is the increased risk of developing secondary melanocytic tumors, such as benign proliferative nodules (BPNs) and malignant melanoma (MM). BPN present as a rapid growth nodule arising within a congenital melanocytic nevus (CMN) that often ulcerates, occurs in children younger than 2 years of age. BPNs arising within a CMN are exceedingly rare after childhood, and very few cases have been described in adults. Despite the worrisome clinical and histologic findings of BPN, most laboratory investigations seem to support their benignity. The distinction between MM and BPN is extremely important, but the histopathology of BPN of GCMN can be a challenge to differentiate from MM. In the recent years, molecular tests that investigate DNA copy number alterations such as fluorescence in situ hybridization and comparative genomic hybridization have shown promise to help guide the diagnosis of ambiguous melanocytic proliferations arising within CMNs. We report the case of a 22-year-old woman with a nodule arising in a GCMN and with an axillary mass suggesting a nodal metastasis of melanoma, and discuss the unusual clinical, histopathologic, and molecular findings that make this case particularly interesting.

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Section: Discussionmentioning

confidence: 75%

Metastatic Melanoma in Association With a Giant Congenital Melanocytic Nevus in an Adult

Machan

Molina-Ruiz

Fernández-Aceñero³

et al. 2015

The American Journal of Dermatopathology

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“…It is into this melanocytic‐neural milieu as a morphologic expression of the various derivations of neural crest cells that rosette‐like profiles were initially reported in an atypical combined melanocytic nevus and later in a Spitz nevus 10,11 . There have been other reports of rosettes in melanocytic nevi yet, because of their rarity, their presence maintains low value for prognostic correlation 12,13 . Rosette‐like structures have been reported in invasive melanomas as well 14–18 …”

Section: Discussionmentioning

confidence: 99%

“…10,11 There have been other reports of rosettes in melanocytic nevi yet, because of their rarity, their presence maintains low value for prognostic correlation. 12,13 Rosette-like structures have been reported in invasive melanomas as well. [14][15][16][17][18] To the best of our knowledge, the present case represents the initial report of rosette-like profiles in the setting of a conventional compound melanocytic nevus without classic Spitz features.…”

Section: Discussionmentioning

confidence: 99%

Rosette‐like formations in melanocytic neoplasms: A case report and literature review

Jaeger

Dehner

2022

J Cutan Pathol

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Homer-Wright-like rosettes are a common finding in neural tumors but seldom seen in melanocytic nevi and melanoma. We report a case of a 23-year-old male with a compound melanocytic nevus with such rosette-like structures and summarize the current literature on this histopathological feature in melanocytic neoplasms. A symmetric, well-circumscribed, compound nevus consisting of aggregations of epithelioid melanocytes with eccentric nuclei and central eosinophilic cytoplasm, resembling Homer-Wright rosettes, was present on biopsy. Immunohistochemical stains strongly supported a melanocytic entity and were negative for NTRK1/2/3, a fusion protein potentially associated with rosette-like structures. We found 17 other cases of benign melanocytic nevi, including 9 atypical Spitz tumors and 6 Spitz nevi, and 11 malignant melanomas, including 3 Spitz melanomas and 4 metastases. We observed remarkable diversity among lesion morphologies containing rosettes, as well as level of prominence and cytology of the rosettes themselves. This case illustrates the morphologic malleability of neural-crest-derived lesions to share microscopic and phenotypic attributes.

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Filigree-like Rete Ridges, Lobulated Nests, Rosette-like Structures, and Exaggerated Maturation Characterize Spitz Tumors With NTRK1 Fusion

Yeh

Busam

McCalmont

et al. 2019

American Journal of Surgical Pathology

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Activating NTRK1 fusions have been described as oncogenic events across the spectrum of Spitz tumors. Herein we report a series of 38 Spitz tumors with NTRK1 fusion. These Spitz tumors have distinctive histopathologic features characterized by filigree-like rete ridges which are elongated, thin and branched, dermal melanocytes arranged in a rosette-like configuration, and marked diminishment of melanocyte size with descent into the dermis. These features are distinct from those of other genetically defined subtypes of Spitz tumors and can aid in microscopic diagnosis and help prioritize in case selection for molecular testing in the rare patients that need targeted therapy.

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Rosette‐like structures in the spectrum of spitzoid tumors

Abstract: While uncommon, rosette-like structures can occur as a focal feature in Spitz nevi and AST. Rosette-like structures may represent a normal morphologic finding in Spitz nevi, and awareness of them may prevent misdiagnosis as a neural tumor or melanoma.

Cited by 3 publications

References 35 publications

Metastatic Melanoma in Association With a Giant Congenital Melanocytic Nevus in an Adult

Metastatic Melanoma in Association With a Giant Congenital Melanocytic Nevus in an Adult

Rosette‐like formations in melanocytic neoplasms: A case report and literature review

Filigree-like Rete Ridges, Lobulated Nests, Rosette-like Structures, and Exaggerated Maturation Characterize Spitz Tumors With NTRK1 Fusion

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