Skin melanocytic tumor
Spitzoid neoplasms, BAP1 inactivated neoplasms, and deep penetrating nevi
Other Spitz nevus variants (angiomatoid, desmoplastic, epithelioid, pagetoid, plexiform)
Author: Christopher S. Hale, M.D.
Topic Completed: 1 March 2013
Minor changes: 15 May 2019
Copyright: 2002-2019, PathologyOutlines.com, Inc.
PubMed Search: Desmoplastic Spitz nevus
See also Spitz nevus
Table of Contents
Definition / general | Epidemiology | Dermoscopy | Clinical features | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosisCite this page: Hale C. Other Spitz nevus variants (angiomatoid, desmoplastic, epithelioid, pagetoid, plexiform). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumormelanocyticdesmoplasticspitz.html. Accessed August 6th, 2020.
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 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
Images hosted on other servers:
Melanocytes with spitzoid appearance
Near-dermal lesion
Various images
Various images
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
