Dermpath-India: Histopathology Image of Spitz Naevus1

Histopathology Image of

Spitz Naevus 1

Cervical metastasis from Spitz nevus of the buccal mucosa. Melanoma Res. 2008 Feb;18(1): 36-39.

A 23-year-old woman was presented with a prolonged history of a small lump in the buccal mucosa. A local excision was performed. The morphology diagnosed a Spitz nevus and she underwent supplementary excision of scar tissue. Two years later a submandibular lump appeared on the ipsilateral side of the neck. Cytology from fine needle aspiration indicated spread of a melanocytic tumor and she underwent a modified supraomohyiod neck dissection. One of the lymph nodes showed an inclusion of cells in the deep layers with epitheloid and spindle cells in a pattern similar to that of the primary oral lesion. The finding suggests a mechanical spread of melanocytes from the Spitz nevus to the regional lymph node. After more than 3 years of follow-up there is no further manifestation of disease. It is believed that this may be an example of how a Spitz tumor, although inherently benign, can spread along lymphatics in a pseudometastatic fashion. To our knowledge this is the first report of an oral Spitz melanoma with metastatic behavior.

Spitz naevus

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Spitz nevus vs 'spitzoid' malignant melanoma. A diagnostic dilemma? Pathologe. 2007;28(6):422-9.

Data from the literature and histopathological findings in six personal cases are used to illustrate criteria that can be applied in differential diagnosis between a Spitz nevus and a spitzoid variant of malignant melanoma. The diagnostic term 'atypical Spitz tumor' is explained; it is used to describe a morphological "grey zone" in which it is not possible to differentiate with adequate certainty between a Spitz nevus and a spitzoid malignant melanoma.