Other Spitz nevus variants (angiomatoid, desmoplastic, epithelioid, pagetoid, plexiform)

Skin melanocytic tumor

Spitzoid neoplasms, BAP1 inactivated neoplasms, and deep penetrating nevi

Topic Completed: 1 March 2013

Minor changes: 3 November 2020

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PubMed Search: Desmoplastic Spitz nevus

See also: Spitz nevus

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Table of Contents

Cite this page: Hale CS. Other Spitz nevus variants (angiomatoid, desmoplastic, epithelioid, pagetoid, plexiform). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumormelanocyticdesmoplasticspitz.html. Accessed March 4th, 2021.

Definition / general

Spitz (spindle and epithelioid cell) nevus with dense eosinophilic stroma
Other Spitz nevus features present (Kamino bodies, etc.)
Uncertain relationship to "desmoplastic (sclerotic) nevus" (Am J Dermatopathol 2011;33:35)

Epidemiology

Mostly young women

Dermoscopy

Eccentric atypical network and central lacunar white zones, short telangiectatic vessels (Am J Dermatopathol 2011;33:628)

Clinical features

Solitary papules on limbs of young adults (not a common site for melanoma)

Microscopic (histologic) description

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, Am J Dermatopathol 2002;24:184, J Cutan Pathol 2009;36:471)

Microscopic (histologic) images

AFIP images

Symmetrical
lesion shows
maturation of
lesional cells

Images hosted on other servers:

Melanocytes with spitzoid appearance

Near-dermal lesion

Various images

Positive stains

HMB45, MelanA, S100

Differential diagnosis

Dermatofibroma, see Acta Derm Venereol 2011;91:74
Desmoplastic melanoma - in situ component present, cells resemble fibroblasts with atypia, negative for MelanA and HMB45