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Skin-Melanocytic tumors
Desmoplastic Spitz nevus
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Revised: 26 October 2009, last major update November 2008
Copyright: (c) 2005-2009, PathologyOutlines.com, Inc.
Clinical
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● Usually limbs of young adults (not a common site for melanoma)
Micro description
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● Resembles classic Spitz nevus (symmetric with inverted wedge shape, infiltration of dermis by relatively bland epithelioid and spindle cells), but dermal fibrosis encircles individual cells and simulates invasion
● Angiomatoid variant exists (Am J Dermatopathol 2000;22:135)
Micro images
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AFIP: Symmetrical lesion shows maturation of lesional cells in the dermis, with attenuated single cells among reticular dermis collagen bundles at the base, but unlike desmoplastic melanoma, the intraepidermal component does not extend substantially beyond the dermal component, and there are no clusters of mitotically active epithelioid melanocytes in the superficial dermis
Other images: #1; #2; #3; #4; #5; #6; desmoplastic angiomatoid Spitz nevus
Positive stains
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● HMB45
● MelanA
● S100
Differential Diagnoses
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● Desmoplastic melanoma - in situ component present, cells resemble fibroblasts with atypia, negative for MelanA and HMB45
End of Skin-Melanocytic Tumors > Desmoplastic Spitz nevus
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