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Atypical Spitz tumor (AST) remains a challenge for both dermatopathologists and clinicians. Fluorescent in situ hybridization (FISH) analysis has been used increasingly to refine outcome prediction in AST. However, up to 40% of ASTs harbor lymph node metastases although the patient does not experience distant metastases or death. For a dermatologist, the most important clinical information regards the likelihood of fatality.
An international team recently examined 75 cases of AST followed after excision by fluorescence in situ hybridization using two probe sets targeting six chromosomal loci. These included 64 cases with uneventful follow-up of 5 years (disease absent, localized, or confined to the sentinel nodes); 8 with evidence of nonfata…