Compound Spitz tumor with a DCTN1-ALK fusion from the arm of a 19-year-old man (case 16). A, Polypoid compound melanocytic tumor, focally ulcerated (hematoxylin and eosin-stained section). B, Proliferation of amelanotic predominantly large epithelioid melanocytes with nuclear atypia. C, DCTN1-ALK kinase fusion. ALK is located on chromosome 2p23 and DCTN1 on chromosome 2p13. Due to genomic rearrangements, exon 1-26 of DCTN1 is fused with exon 20 to 29 of ALK, which contains the tyrosine kinase domain. The in-frame junction of the fusion transcript was confirmed with Sanger sequencing.