NTRK Gene Fusion Detection in Atypical Spitz Tumors

Atypical Spitz tumors (AST) deviate from stereotypical Spitz nevi for one or more atypical features and are now regarded as an intermediate category of melanocytic tumors with uncertain malignant potential. Activating NTRK1/NTRK3 fusions elicit oncogenic events in Spitz lesions and are targetable with kinase inhibitors. However, their prevalence among ASTs and the optimal approach for their detection is yet to be determined. A series of 180 ASTs were screened with pan-TRK immunohistochemistry and the presence of NTRK fusions was confirmed using FISH, two different RNA-based NGS panels for solid tumors, and a specific real time RT-PCR panel. Overall, 26 ASTs showed pan-TRK immunostaining. NTRK1 fusions were detected in 15 of these cases showing cytoplasmic immunoreaction, whereas NTRK3 was detected in one case showing nuclear immunoreaction. Molecular tests resulted all positive in only two ASTs (included the NTRK3 translocated), RNA-based NGS and real time RT-PCR were both positive in three cases, and FISH and real time RT-PCR in another two cases. In seven ASTs NTRK1 fusions were detected only by FISH and in two cases only by real time RT-PCR. The frequency of NTRK fusions in ASTs is 9%, with a clear prevalence of NTRK1 compared to NTRK3 alterations. Pan-TRK immunohistochemistry is an excellent screening test. Confirmation of NTRK fusions may require the use of different molecular techniques.

Lipoprotein lipase in guinea-pig adrenals: activity, mRNA, immunolocalization and regulation by ACTH

ABSTRACT Lipase activity in homogenates of guinea-pig adrenals was studied under conditions which exclude the hormone-sensitive lipase/cholesterol ester hydrolase. Antibody inhibition and chromatography on heparin–Sepharose showed that most of the activity was due to lipoprotein lipase (LPL), and that there was only a small amount of hepatic lipase activity. Northern blot analysis of total RNA demonstrated the same three adrenal LPL mRNA species (1·8, 3·1 and 3·5 kb) as were found in adipose tissue and heart. Hence, at least part of the LPL activity in adrenals is due to enzyme synthesized within the tissue. Immunolocalization showed that LPL was associated with the endothelium of blood vessels throughout the gland. In addition, there was cytoplasmic immunoreaction, suggesting that lipase was synthesized in a subpopulation of cells in the transitional zone between the fasciculata and reticularis layer of the cortex, particularly over lipid-filled cells. There was also intense immunofluorescence over scattered cells in the adrenal medulla. Treatment with an ACTH analogue depot (20 IU, i.m.) for 11 days induced a 12-fold increase in serum cortisol and increased adrenal weight 2·2-fold. The treatment induced increases in LPL mRNA (about twofold), LPL activity and in the number of cells in the adrenal cortex which gave an immunoreaction for LPL. Journal of Endocrinology (1991) 129, 213–220