Table 1.
Features of ALK fused Spitz tumors.
| Case | Age (yrs) | Gender | Location | Final Diagnosis# | Clinical History | Clinical follow-up | Copy number transition in ALK | Gain or Amplification of ALK fusion* | Studies performed |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 4 | F | arm | Spitz nevus | 0.5 cm lesion | NED 3 months | No | No | FISH, IHC |
| 2 | 15 | M | knee | Spitz nevus | 0.7 mm verrucous papule | Re-excision, NED 9 months | No | No | FISH, IHC |
| 3 | 17 | F | wrist | Spitz nevus | 1.2 cm exophytic pink nodule | Re-excision, lost to follow-up | NA | NA | IHC |
| 4 | 24 | F | lower back | Spitz nevus | 1.3 cm oval, growing, pink lesion, basal cell carcinoma? | NED 9 months | FISH | No | FISH, IHC |
| 5 | 31 | M | back | Spitz nevus | pink papule, in prior radiation field for Hodgkin’s lymphoma | lost to follow-up | NA | NA | IHC |
| 6 | 39 | F | buttock | Spitz nevus | irritated Spitz | lost to follow-up | No | No | FISH, IHC |
| 7 | 0.4 | F | forearm | atypical Spitz tumor | pyogenic granuloma/hemangioma | Re-excision, NED 3 months | CGH | No | CGH, IHC |
| 8 | 3 | M | cheek | atypical Spitz tumor | xanthogranuloma versus nevus versus molluscum | Re-excision, lost to follow-up | No | No | CGH, IHC |
| 9 | 4 | F | cheek | atypical Spitz tumor | 1.5 cm pink plaque with border of pigmentation and cobblestone texture | Re-excision, lost to follow-up | CGH | No | CGH, IHC |
| 10 | 4 | F | thigh | atypical Spitz tumor | 5.5 mm papule, rapid growth noted while on maintenance treatment for B-cell acute lymphoblastic leukemia | Re-excision, NED 9 months | CGH, FISH | AMP (CGH/FISH) | CGH, FISH, IHC |
| 11 | 5 | F | ear | atypical Spitz tumor | recently enlarging | Re-excision, lost to follow-up | CGH | AMP (CGH/FISH) | CGH, FISH, IHC Seq |
| 12 | 5 | M | knee | atypical Spitz tumor | ulcerated 0.6 cm pink papule | lost to follow-up | CGH, FISH | No | CGH, FISH, IHC |
| 13 | 5 | F | elbow | atypical Spitz tumor | growing 0.5 cm exophytic pink papule | Re-excision, lost to follow-up | No | No | FISH, IHC |
| 14 | 6 | M | leg | atypical Spitz tumor | pink nodule | lost to follow-up | No | No | CGH, FISH, IHC |
| 15 | 7 | F | scalp | atypical Spitz tumor | rapidly growing pink and black papule | Re-excision, NED 3 months | No | No | CGH, IHC |
| 16 | 7 | F | lower leg | atypical Spitz tumor | Unavailable | Re-excision, NED 4 months | No | AMP (CGH) | CGH, IHC |
| 17 | 7 | M | forearm | atypical Spitz tumor | pyogenic granuloma | Re-excision, NED 9 months | No | No | FISH, IHC |
| 18 | 7 | F | forearm | atypical Spitz tumor | 1.5 cm infiltrative nodule | Re-excision, NED 9 months | No | No | CGH, FISH, IHC |
| 19 | 9 | F | cheek | atypical Spitz tumor | not available | Re-excision, NED 7 months | No | No | CGH, Seq |
| 20 | 11 | M | chest | atypical Spitz tumor | Spitz nevus | Re-excision, lost to follow-up | CGH | GAIN (CGH) | CGH, IHC |
| 21 | 13 | F | arm | atypical Spitz tumor | keloid | Re-excision, NED 3 months | No | No | CGH, IHC |
| 22 | 16 | F | ear | atypical Spitz tumor | 1 cm exophytic, pink papule | Re-excision, NED 12 months | No | No | FISH, IHC |
| 23 | 17 | F | buttock | atypical Spitz tumor | 1 cm pink plaque | Re-excision, NED 8 months | No | No | CGH, IHC |
| 24 | 17 | M | hand | atypical Spitz tumor | 1 cm exophytic, pink, nodule | Re-excision, NED 9 months | No | No | FISH, IHC |
| 25 | 18 | F | lower abdomen | atypical Spitz tumor | not available | Re-excision, SLNBx -, NED 4months | CGH | No | CGH, IHC |
| 26 | 21 | M | forearm | atypical Spitz tumor | 0.6 cm lesion | Re-excision, lost to follow up | No | No | FISH, IHC |
| 27 | 27 | F | lower back | atypical Spitz tumor | angiomatous plaque with central pigmentation | Re-excision, NED 18 months | CGH | No | CGH, IHC |
| 28 | 64 | F | leg | atypical Spitz tumor | 0.6 cm lesion | Re-excision, lost to follow-up | No | No | FISH, IHC |
| 29 | 5 | M | buttock | Spitzoid melanoma, > 7 mm | pyogenic granuloma | Re-excision, NED 13 months | No | No | CGH, Seq |
| 30 | 13 | F | forearm | Spitzoid melanoma, 7.1 mm | Inflamed pink papule | Re-excision, SLNBx- NED 40 months | No | No | FISH, IHC |
| 31 | 17 | F | foot | Spitzoid melanoma, 1.75 mm | traumatized melanocytic neoplasm | Re-excision, SLNBx -, NED 21 months | No | No | CGH, Seq |
| 32 | 21 | M | arm | Spitzoid melanoma, 3.5 mm | 0.8 mm pigmented nodule | Re-excision, NED 16 months | No | No | CGH, FISH, IHC |
NED: no evidence of disease SLNBx: sentinel lymph node biopsy FISH: fluorescence in situ hybridization CGH: comparative genomic hybridization IHC: immunohistochemistry
#
Breslow depth is provided for the melanomas.
*
Amplification defined as log2 copy number ratio > 1.5 (CGH) or > 5 signals/cell (FISH).