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 Pigmented Spindle Cell Nevus (Reed Nevus)

          Dr Sampurna Roy MD

                Dermatopathology Quiz Case No.59

 
   Melanocytic Tumours

          

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August 2010 
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Melanocytic tumours
              
1. Acquired Melanocytic Naevus

Ancient Naevus
Halo naevus
Balloon cell naevus
Combined Naevus
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2. Spindle and epithelioid cell naevi

Spitz naevus
Pigmented spindle cell naevus

3. Blue naevi

Common blue naevus 
Cellular blue naevus


4. Dermal melanocytoses

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Naevus of Ito  
Mongolian spot  

5. Congenital melanocytic naevi                                              
6. Dysplastic melanocytic naevi

Pathology of the Eyelid

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Pigmented spindle cell nevus (Reed Nevus):

Pigmented spindle cell naevus is  regarded as a distinct entity and not part of spindle cell variant of Spitz naevus.

Clinically, these lesions present as symmetrical ,sharply circumscribed, darkly pigmented nodule or papule ( usually less than 0.6 cm in diameter).  Image1  ; Image2

Histologically, the tumour consists of spindle shaped cells in nests with formation interconnecting  fascicles.       Image1  ; Image2  ;  Image3  ; Image4.

Prominent vertical orientation of cells are noted. The tumour grows in an expansile. These are heavily pigmented  and contains melanophages.

Kamino bodies (similar to Spitz) are noted in pigmented spindle cell naevus. Junctional clefting is noted in some cases.

Differential diagnosis include melanoma. Unlike melanoma these are symmetrical lesions and display maturation of cells in the deeper part of the lesion. Pagetoid spread of cells is limited to the lower half of the epidermis.   Visit: Dermpath-India                        

                     

Abstracts:

Pigmented spindle-cell nevus: A melanoma simulator. Dermatology Online Journal 2004;10 (2): 5

Pigmented spindle cell naevus of reed presenting in the conjunctiva.Acta Ophthalmol Scand. 2000 Feb;78(1):104-6.

Pigmented spindle cell nevus: a clinicopathologic analysis of ninety-five cases.J Am Acad Dermatol. 1993 Apr;28(4):565-71.

The histologic spectrum of pigmented spindle cell nevus: a review of 120 cases with emphasis on atypical variants.Hum Pathol. 1991 Jan;22(1):52-8.

The pigmented spindle cell tumor of Reed: an underdiagnosed lesion.Semin Diagn Pathol. 1987 Feb;4(1):75-87.

Pigmented spindle cell nevus. Clinical and histologic review of 90 cases.Am J Surg Pathol. 1984 Sep;8(9):645-53.

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Pigmented melanocytic lesions causing diagnostic problems

Prognostic parameters of melanoma

Lentigo maligna melanoma

Superficial spreading melanoma

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Neurotropic melanoma

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Soft TissueTumours of Uncertain Differentiation               

Notochordal Tumour - Chordoma

Extra-adrenal Paraganglioma

Epidermal tumours of the Eyelid

Mesenchymal Tumours of the Eyelid

Melanocytic tumours of the Eyelid


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