Alireza Sepehr, Beth Israel Deaconess Medical Center and Harvard Medical School
Rossitza Lazova, Yale School of Medicine
Technological developments in several technology research and development areas, including histologic profiling of tissues with PIMS and high spatial resolution imaging, have advanced the diagnostic accuracy for melanocytic lesions compared to traditional histological analysis. We developed classification algorithms based on differential peptide distributions to distinguish Spitz nevi (benign), Spitzoid malignant melanomas [1,2], and atypical Spitzoid neoplasms (biopsies for which an accurate diagnosis could not be determined based on histology alone). Atypical neoplasms were diagnosed with 100% accuracy (n=120) by IMS analysis, whereas histological analysis misdiagnosed 20 of these samples. The developed model was used in an interesting melanocytic lesion case study involving a mother with malignant melanoma and her newborn child . The child was born with multiple melanocytic lesions on his torso. Several lesions were biopsied and could not be definitively classified as benign or malignant using histology. Both the primary lesion from the mother and two of the lesions from the baby were analyzed via imaging mass spectrometry. While the mother’s lesion were malignant, the child’s lesions were benign. In this case, the advancement and application of IMS technologies achieved the ultimate goal of these research efforts – improved patient care and quality of life due to the avoidance of unnecessary surgical procedures.
1. Caprioli RM, Seeley EH Method for differentiating spitz nevi from spitzoid malignant melanoma. Patent US 8,822,159. September 2, 2014. Return to text.
2. Lazova R, Seeley EH, Keenan M, Gueorguieva R, Caprioli RM (2012) Imaging mass spectrometry–a new and promising method to differentiate Spitz nevi from Spitzoid malignant melanomas. Am J Dermatopathol 34 (1):82-90. PMCID: 3263382. Return to text.
3. Alomari A, Glusac EJ, Choi J, Hui P, Seeley EH, Caprioli RM, Watsky KL, Urban J, Lazova R (2015) Congenital melanocytic nevi versus metastatic melanoma in a newborn to a mother with melanoma – diagnosis supported by sex chromosome analysis and imaging mass spectrometry. J Cutan Pathol Accepted. Return to text.