TY - JOUR
T1 - Intradermal spitz nevi
T2 - A rare subtype of spitz nevi analyzed in a clinicopathologic study of 74 cases
AU - Plaza, Jose A.
AU - De Stefano, Danielle
AU - Suster, Saul
AU - Prieto, Victor G.
AU - Kacerovska, Denisa
AU - Michal, Michal
AU - Sangueza, Martin
AU - Kazakov, Dmitry V.
PY - 2014/4
Y1 - 2014/4
N2 - Spitz nevi are acquired melanocytic lesions with a wide histomorphological spectrum; reliable distinction from spitzoid melanoma is often difficult. Misdiagnoses of benign spitzoid tumors as spitzoid melanomas and vice versa are attributable to a frequently disturbing morphology and inconsistent or poorly defined histological criteria for diagnosis. Many recognized histological variants of Spitz nevi have been described, including the intradermal Spitz. Histopathologic descriptions of intradermal Spitz nevi have been done in the past; however, large studies addressing their histological spectrum have been lacking. We have retrospectively assessed the morphological features in 74 cases of intradermal Spitz nevi, excluding tumors clearly defined as atypical Spitz nevi and Spitzoid melanomas, to further delineate their histological spectrum. The patient's ages ranged from 5 to 81 years (median: 27). Anatomic location included: the upper extremities (27 cases), followed by head and neck (22 cases), lower extremities (9 cases), back (8 cases), buttock (5 cases), chest (1 case), and vulva (1 case). In 1 case, the anatomic location of the lesion was not available. Different histological variants were observed including hyalinized, polypoid, desmoplastic, angiomatoid, and halo Spitz. Morphological features evaluated included symmetry (100%), cell type (epithelioid 42%, spindle 16%, mixed 42%), maturation (85%), pigmentation (26%), chronic inflammation (24%), and mitotic activity (38%). Mild atypia was seen in 36 cases (49%), moderate atypia was seen in 28 cases (38%), and severe atypia was seen in 10 cases (14%). Intradermal Spitz nevus is a distinctive type of Spitz nevus that sometimes can be difficult to define given the unusual features that these lesions can show; thus, strict application of well-defined histological criteria and awareness of their morphological spectrum will facilitate definitive diagnosis.
AB - Spitz nevi are acquired melanocytic lesions with a wide histomorphological spectrum; reliable distinction from spitzoid melanoma is often difficult. Misdiagnoses of benign spitzoid tumors as spitzoid melanomas and vice versa are attributable to a frequently disturbing morphology and inconsistent or poorly defined histological criteria for diagnosis. Many recognized histological variants of Spitz nevi have been described, including the intradermal Spitz. Histopathologic descriptions of intradermal Spitz nevi have been done in the past; however, large studies addressing their histological spectrum have been lacking. We have retrospectively assessed the morphological features in 74 cases of intradermal Spitz nevi, excluding tumors clearly defined as atypical Spitz nevi and Spitzoid melanomas, to further delineate their histological spectrum. The patient's ages ranged from 5 to 81 years (median: 27). Anatomic location included: the upper extremities (27 cases), followed by head and neck (22 cases), lower extremities (9 cases), back (8 cases), buttock (5 cases), chest (1 case), and vulva (1 case). In 1 case, the anatomic location of the lesion was not available. Different histological variants were observed including hyalinized, polypoid, desmoplastic, angiomatoid, and halo Spitz. Morphological features evaluated included symmetry (100%), cell type (epithelioid 42%, spindle 16%, mixed 42%), maturation (85%), pigmentation (26%), chronic inflammation (24%), and mitotic activity (38%). Mild atypia was seen in 36 cases (49%), moderate atypia was seen in 28 cases (38%), and severe atypia was seen in 10 cases (14%). Intradermal Spitz nevus is a distinctive type of Spitz nevus that sometimes can be difficult to define given the unusual features that these lesions can show; thus, strict application of well-defined histological criteria and awareness of their morphological spectrum will facilitate definitive diagnosis.
KW - Angiomatoid spitz nevus
KW - Desmoplastic spitz nevus
KW - Epithelioid spitz
KW - Intradermal spitz nevus
KW - Pigmented spitz nevus
KW - Spitz
KW - Spitz nevi
UR - http://www.scopus.com/inward/record.url?scp=84899535328&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899535328&partnerID=8YFLogxK
U2 - 10.1097/DAD.0b013e3182a64bb9
DO - 10.1097/DAD.0b013e3182a64bb9
M3 - Article
C2 - 24736667
AN - SCOPUS:84899535328
SN - 0193-1091
VL - 36
SP - 283
EP - 297
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 4
ER -