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PRAME expression in melanocytic proliferations with intermediate histopathologic or spitzoid features
Shyam S Raghavan1, Jennifer Y Wang2,3, Shirley Kwok2
1Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Journal of Cutaneous Pathology
|July 24, 2020
Summary
PRAME expression helps differentiate melanoma from benign lesions. While usually absent in Spitz nevi and atypical Spitz tumors, rare cases can show PRAME, requiring careful interpretation.
Area of Science:
- Dermatopathology
- Oncology
- Immunohistochemistry
Background:
- PRAME (PReferentially expressed Antigen in MElanoma) is a marker for melanoma.
- Its expression in intermediate melanocytic and spitzoid lesions is not well-established.
Purpose of the Study:
- To evaluate PRAME expression in melanocytic proliferations with intermediate or spitzoid features.
- To determine the utility of PRAME immunohistochemistry in differentiating these lesions.
Main Methods:
- Immunohistochemical analysis of PRAME in 112 melanocytic proliferations.
- Defined diffuse PRAME expression as nuclear staining in ≥60% of lesional melanocytes.
Main Results:
- 95.8% of non-spitzoid melanomas showed diffuse PRAME expression.
- PRAME was negative in 95.6% of benign and dysplastic nevi.
- Most Spitz nevi and atypical Spitz tumors lacked PRAME, but rare cases showed expression.
Conclusions:
- Diffuse PRAME expression is predominantly seen in malignant melanoma.
- PRAME is a useful diagnostic aid for atypical melanocytic proliferations but requires cautious interpretation in spitzoid neoplasms due to infrequent expression.
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