Spitz nevus

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Spitz nevus
Spitz nevus.jpg
Spitz nevus
Classification and external resources
Specialty Oncology
ICD-10 D22 (ILDS D22.L32)
ICD-O M8770/0
DiseasesDB 29807
eMedicine article/1059623
MeSH D018332

A Spitz nevus (also known as an epithelioid and spindle-cell nevus,[1] benign juvenile melanoma,[1]:691 and "Spitz's juvenile melanoma"[2]) is a benign melanocytic nevus, a type of skin lesion, affecting the epidermis and dermis.[3]

The name juvenile melanoma is generally no longer used as it is misleading: it is not a melanoma, it is a benign lesion; and it can also occur in adults, not only in children.[4]

Epidemiology[edit]

Spitz nevi are uncommon. Their annual incidence was estimated in a coastal population of sub-tropical Queensland to be 1.4 cases per 100,000 people. For comparison, the annual incidence of melanoma in the same population, which is high by world standards[5] is 25.4 cases per 100,000 people.[4]

Although they are most commonly found on people in their first two decades of life,[3] the age range for people with Spitz nevi is from 6 months to 71 years, with a mean age of 22 years and a median age of 19 years.[4]

Pathology[edit]

Micrograph of a Spitz nevus showing the characteristic vertically arranged nests of cells ("hanging bananas"). H&E stain.

The cause of Spitz nevi is not yet known. There is an association with sunburn, but causation is not established.[3] Genetic studies of Spitz nevi have shown that most cells have the normal number of chromosomes, however a minority (25%) of cells have been shown to contain extra copies of parts of some chromosomes, such as the short arm of chromosome 11 (11p).[3]

Spitz nevi characteristically have vertically arranged nests of nevus cells that have both a spindled and an epithelioid morphology. Apoptotic cells may be seen at the dermoepidermal junction. The main histologic differential diagnoses are pigmented spindle cell nevus and malignant melanoma.

Eponym[edit]

The lesion is named after Sophie Spitz, the pathologist who originally described it in 1948.[6]

See also[edit]

References[edit]

  1. ^ a b James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1728–30. ISBN 1-4160-2999-0. 
  3. ^ a b c d LeBoit, PE, Burg G, Weedon D, Sarasin A. (Eds) World Health Organization Classification of Tumours: Pathology and Genetics of Skin Tumours. Lyon: IARCPress. 2006.
  4. ^ a b c Crotty, K. Spitz Naevus: Histological features and distinction from malignant melanoma. Australasian Journal of Dermatology. 38 (suppl): S49-S53. 1997.
  5. ^ Ries LAG, et al., eds. SEER Cancer Statistics Review, 1975–2000. Bethesda, MD: National Cancer Institute; 2003: Tables XVI-1-9.
  6. ^ Spitz S. Melanomas of childhood. Am. J. Pathol.1948;24:591-609.