ABSTRACT
O nevo de Spitz pigmentado consiste em uma lesão melanocítica benigna com características peculiares. Geralmente, melanoma é considerado no diagnóstico diferencial desta lesão, bem como o nevo de Reed. A dermatoscopia representa uma parte relevante da abordagem diagnóstica e, portanto, ela permite um estudo mais eficiente dessas lesões dermatológicas. O presente relato de caso é sobre uma paciente com dois nevos de Spitz pigmentados de localização no tronco e história familial de melanoma, no qual a dermatoscopia associada à histopatologia foram cruciais para o diagnósticos das lesões.
Subject(s)
Humans , Female , Young Adult , Reed-Sternberg Cells , Nevus, Epithelioid and Spindle Cell , Nevus, Spindle CellABSTRACT
Deep penetrating nevus (DPN) is a distinctive melanocytic nevus firstly reported by Seab et al. in 1989. It is characterized by its dark pigmentation, occurring mostly on the face, neck, or shoulder, and usually measures less than 1 cm in diameter. Since it has histologic similarities with other cutaneous pigmented lesions such as combined nevus, blue nevus, Spitz nevus, and pigmented spindle cell nevus, it is often difficult to diagnose and it may be clinically and histologically mistaken for a malignant melanoma. There have been 2 reported cases of DPN in the Korean dermatologic literatures; therefore, we report a case of DPN mimicking malignant melanoma.
Subject(s)
Melanoma , NAD , Neck , Nevus , Nevus, Blue , Nevus, Epithelioid and Spindle Cell , Nevus, Pigmented , Nevus, Spindle Cell , Pigmentation , ShoulderABSTRACT
Spitz and Reed nevi, also called spindle and/or epithelioid cell nevi, are a special group of melanocytic lesions due to their peculiar clinical, dermoscopic and histopathological features. The study of these nevi is of great interest because both their nomenclature and classification are still a matter of discussion. Most importantly, the difficulty to differentiate them from melanoma can lead to inadequate therapies. In this context, dermoscopy, a link between clinical and anatomopathological examinations, appears as a helpful diagnostic tool whose accuracy can reach 93%. "Borderline" lesions are still a great challenge and object of research, including molecular studies. The present study explores the relevant characteristics of these nevi, with emphasis on dermoscopic findings, aiming at understanding their natural history, as well as discussing treatment and patient follow-up.
Os nevos de Spitz e de Reed, ou também chamados nevos de células fusiformes e/ou epitelióides, formam um grupo especial de lesões melanocíticas, por suas características peculiares, tanto clínicas como dermatoscópicas e histopatológicas. Torna-se grande o interesse no estudo desses nevos, pois tanto a nomenclatura como a classificação ainda são motivos de debate e, sobretudo, a dificuldade de diferenciação com o melanoma pode gerar condutas terapêuticas inadequadas. Neste contexto, surge a dermatoscopia, elo entre o exame clínico e o anatomopatológico, como método diagnóstico auxiliar importante cuja acurácia pode chegar a 93%. A grande dificuldade ainda são as lesões "borderline", motivo de pesquisas, incluindo estudos moleculares. O presente estudo aborda os aspectos relevantes das características destes nevos, com ênfase nos achados dermatoscópicos, buscando o entendimento da sua história natural, além da discussão quanto ao tratamento e seguimento dos pacientes.
Subject(s)
Humans , Nevus, Spindle Cell/pathology , Skin Neoplasms/pathology , Diagnosis, Differential , Nevus, Epithelioid and Spindle Cell/diagnosis , Nevus, Epithelioid and Spindle Cell/pathology , Nevus, Epithelioid and Spindle Cell/therapy , Nevus, Spindle Cell/diagnosis , Nevus, Spindle Cell/therapy , Prognosis , Skin Neoplasms/diagnosis , Skin Neoplasms/therapyABSTRACT
Os autores relatam um caso de nevo de Reed, lesão que apresenta aspecto histológico de malignidade, mas tem evolução benigna. Paciente de 48 anos, masculino, cor parda, apresentava pterígio nasal no olho direito, associado a uma lesão pequena e pouco pigmentada localizada na cabeça do mesmo. Realizou-se exérese de ambos, sem intercorrências, sem sinais de recidiva. O exame histopatológico revelou lesão com bordas definidas, restrita ao epitélio, constituída por células fusiformes perpendiculares à superfície, com pigmentação melânica esparsa. O diagnóstico inicial foi nevo de Spitz, mas, posteriormente, chegou-se à conclusão que se tratava do nevo de células fusiformes de Reed. O presente relato é o segundo na literatura mundial e o primeiro no Brasil.
The authors report one case of nevus of Reed, which has histological aspect of malignancy, but a benign evolution. A 48-years-old brown skin male presented nasal pterygium in right eye, associated with a small and poorly pigmented lesion located on the pterygium head. Both were excised without complications and, currently, there is no recidivation. The histopathological examination revealed one lesion with defined edges, limited to the epithelium, consisted of spindle cells perpendiculars to the surface and with sparse melanin pigmentation. The initial diagnosis was Spitz nevus, but, afterwards, we concluded that was the spindle cell nevus of Reed. This report is the second in the international literature and the first in Brazil.
Subject(s)
Humans , Male , Middle Aged , Nevus, Spindle Cell/surgery , Nevus, Spindle Cell/diagnosis , Nevus, Spindle Cell/pathology , Conjunctival Neoplasms/surgery , Conjunctival Neoplasms/diagnosis , Conjunctival Neoplasms/pathology , Pterygium/surgery , Pterygium/diagnosis , Pterygium/pathology , Slit Lamp MicroscopyABSTRACT
O nevo de Reed ou nevo de células fusiformes pigmentado pode ser um simulador do melanoma cutâneo. Apresenta, entretanto, diferentes características dermatoscópicas e histopatológicas. Trata-se de relato de três pacientes com apresentações clínicas, dermatoscópicas e histopatológicas distintas, correlacionando-as no auxílio diagnóstico deste com o melanoma e nevo de Sptiz.
Reed nevus or pigmented spindle-cell nevus may mimic cutaneous melanoma; however, its dermoscopic and histopathological characteristics are different. This case report describes three patients with distinct clinical, dermoscopic and histopathological presentations, which were correlated to enable a differential diagnosis to be made between melanoma and Spitz nevus.
Subject(s)
Adolescent , Child , Female , Humans , Male , Dysplastic Nevus Syndrome/pathology , Melanoma/pathology , Nevus, Spindle Cell/pathology , Skin Neoplasms/pathology , Dermoscopy , Diagnosis, DifferentialABSTRACT
Pigmented spindle cell nevus (PSCN) is a solitary heavily pigmented macule or papule that usually occurs on the lower legs of women in the second decade of life. Histologically, fascicles of uniform, elongated, pigmented nevoid cells at the dermo-epidermal junction tend to fuse with neighboring nests. PSCN should be differentiated from Spitz nevus, dysplastic nevus, and malignant melanoma. For making the differential diagnosis of PSCN from malignant melanoma of nevoid cells, the overall symmetry, relative uniformity, maturation with depth and no nuclear atypia are important clues. A 3-year-old girl presented with a black papule on the anterior aspect of the ankle. We diagnosed PSCN by the histologic findings and the specific "starburst" dermoscopic pattern.
Subject(s)
Animals , Female , Humans , Ankle , Dermoscopy , Diagnosis, Differential , Dysplastic Nevus Syndrome , Leg , Melanoma , Nevus, Epithelioid and Spindle Cell , Nevus, Spindle Cell , Child, PreschoolABSTRACT
Este estudo apresenta achados microscópicos do nevo pigmentado de células fusiformes, designado como nevo de Reed, os quais resultaram de exames microscópicos realizados em múltiplos cortes de lesão de pele. Apresenta ainda a revisão de literatura pertinente. Os achados clínicos e microscópicos são consistentes com os dados da literatura descritos, originariamente, por Reed e colaboradores. O nevo de Reed é uma lesão melanocítica benigna, que, no entanto, pode ser equivocadamente identificada como um melanoma malígno. As lesões melanocíticas que podem ser confundidas com melanoma malígno devem ser avaliadas cuidadosamente, a fim de obter-se um diagnóstico acurado, e seguir-se a conduta pertinente.
This paper presents the findings of microscopic studies of the PigmentedSpindle-cell Nevus, called Nevus of Reed, carried on multiple sections of skin lesion. It presents, as well, a review of the related literature. The clinical andmicroscopic findings coincide with those originally described by Reed andcolleagues. The Nevus of Reed is a benign melanocytic lesion, which, however,can be easily misdiagnosed as a malignant melanoma. Therefore, in case of suchlesions, all efforts should be made to render an accurate diagnosis, and thus, toprovide the adequate therapy.
Subject(s)
Humans , Melanoma , Nevus , Nevus, Spindle CellABSTRACT
Deep penetrating nevus is a recently described variant of melanocytic nevi. It's clinical and histopathological features can be confused with malignant melanoma, blue nevus, Spitz nevus, pigmented spindle cell nevus, or congenital melanocytic nevus. Histopathologically, the lesions are characterized by loosely-organized nests of slightly to distinctively pleomorphic pigmented cells which deeply penetrate the reticular dermis and often extend into the subcutis. We report a case of deep penetrating nevus on the right arm of a 21-year-old female.
Subject(s)
Female , Humans , Young Adult , Arm , Dermis , Melanoma , Nevus , Nevus, Blue , Nevus, Epithelioid and Spindle Cell , Nevus, Pigmented , Nevus, Spindle CellABSTRACT
Pigmented spindle cell nevus was described as a variant of spindle and epithelioid cell nevus (Spitz nevus). However, it hs been classified as a separate disease because of the presence of large pigmented cells confined to the epidermis and papillary dermis. Pigmented epithelioid cell nevus is considered as a counterpart to pigmented spindle cell nevus, because it has similar clinicopathologic features to those of pigmented spindle cell nevus, except for tumor cells being entirely composed of large epithelioid cells. Herein, we report a case of a 31 year-old woman with a deeply-pigmented nodule which was entirely composed of large epithelioid cells, and showed many histologic findings of pigmented epithelioid cell nevus.
Subject(s)
Adult , Female , Humans , Dermis , Epidermis , Epithelioid Cells , Nevus , Nevus, Epithelioid and Spindle Cell , Nevus, Spindle CellABSTRACT
Pigmented spindle cell nevus (PSCN) is often interpreted as a Spitz nevus or misdiagnosed as a malignant melanoma. Some authors consider PSCN as a pigmented variant of Spitz nevus, but many dermatologists classify it as a separate disease. We report a case of pigmented spindle cell nevus which occurred in a 4-year-old boy. The lesion was a well-demarcated, 3x3mm sized, black macule on the dorswn part of the 4th finger, left hand. The histopathologic findings of the excisional biopsy specimen revealed the proliferation of uniform, spindle shaped, pigmented melanocytes at the dermoepidermal junction and sharply defined lateral margins. The pathologic features were consistent with PSCN.
Subject(s)
Child, Preschool , Humans , Male , Biopsy , Fingers , Hand , Melanocytes , Melanoma , Nevus, Epithelioid and Spindle Cell , Nevus, Spindle CellABSTRACT
Se trata de paciente femenina de 25 años de edad, quien consulta por presentar desde hace 1 año, ®mancha oscura en antebrazo derecho¼, la cual presentó prurito ocasional y crecimiento acelerado durante los últimos 3 meses. Niega antecedentes de importancia. Al examen físico fototipo de piel Fitzpatrick III apreciándose mácula redonda, hiperpigmentada, color marrón oscuro, de 5 mm de diámetro, localizada sobre la cara dorsal del antebrazo derecho (Figura 1). A la dermatoscopia, utilizando un equipo Dermlitefoto® (3 gen) con aumento de 10x, se observó una lesión redondeada de 5 mm de diámetro, con predominio de los colores marrón claro, marrón oscuro y negro, con un área central más oscura, donde no se reconocieron estructuras. Hacia la periferia se identificó un área más clara como una corona y múltiples glóbulos marrones distribuidos regularmente en toda la periferia de la lesión, tomando un patrón de estallido de estrella, globular o patrón targetoide. Se observó un esbozo de red de pigmento y algunos puntos negros periféricos
Subject(s)
Adult , Humans , Female , Nevus, Spindle Cell/diagnosis , Skin Diseases , Dermatology , VenezuelaABSTRACT
PURPOSE: Pigmented spindle cell tumor of the palpebral conjunctiva is very rare, and most of the tumors arise at extremities or trunk. To our best knowledge, no case has been repoted in Korea so far. We report one case of pigmented spindle cell nevus with literature review. METHODS: A 21 years-old male patient complaining of mass on the left upper palpebral conjunctiva underwent excisional biopsy with minimal touch technique. RESULTS: On histopathologic examination, the mass consisted of small, regular and spindle cells with pigmentation. And HMB-45 and CD-34 stains were negative, while S-100 stain was weakly positive. CONCLUSIONS: We report one case of pigmented spindle cell nevus as the first case in Korea.
Subject(s)
Humans , Male , Young Adult , Biopsy , Coloring Agents , Conjunctiva , Extremities , Korea , Nevus, Spindle Cell , PigmentationABSTRACT
Pigmented spindle cell nevus is a rare lesion characterized by uniform, expanding, heavily pigmented macule or papule, usually located on the thigh of a woman in the second and third decade of life. It is often misdiagnosed as Spitz nevus or malignant melanoma. A 30-year-old woman presented with black, smooth macule on her thigh. Histopathological examination confirmed the diagnosis as pigmented spindle cell nevus. This is thought to be a more typical case than previously reported two domestic cases.
Subject(s)
Adult , Female , Humans , Diagnosis , Melanoma , Nevus, Epithelioid and Spindle Cell , Nevus, Spindle Cell , ThighABSTRACT
Pigmented spindle cell nevus (PSCN) was first described by Reed et al. in 1975 as a distinctive form of nevocellular nevus. Although some authors consider PSCN to be a pigmented variant of Spitz nevus, most classify it as a separate disease. We encountered a two year old boy with deeply pigmented macule on the left foot dorsum. It's histologic features were sharply demarcated lateral margin, confinement above reticular dermis and entirely composed of heavily pigmented spindle cells. There were no atypical mitotic fugures or nuclear pleomorphism, and cell size was uniform. The pathologic features were consistent with PSCN.
Subject(s)
Humans , Infant , Male , Cell Size , Dermis , Foot , Nevus , Nevus, Epithelioid and Spindle Cell , Nevus, Spindle CellABSTRACT
We report a case of pigmented spindle cell nevus which occurred in a 4-year-old male. Several months earlier, his mother noticed a 3x3mm sized annular, hyperpigmented macule on his right thigh. Histopathologic findings showed nests of spindle cells with sharply defined lateral margins in the dermoepidermal junction and cleft around the spindle cell nests with heavy melanin pigmentation.
Subject(s)
Child, Preschool , Humans , Male , Melanins , Mothers , Nevus, Spindle Cell , Pigmentation , ThighABSTRACT
We report a case of pigmented spindle cell nevus occurred in a 4-year-old girl. The lesion was well-demarcated, 2.5 x 3mm sized black macule on the left thenar area. The histopathologic findings of excisional biopsy specimen revealed the prociferation of uniform spindle-shaped pigmented melanocytes at the dermoepidermal junction and sharply definded lateral margins.
Subject(s)
Child, Preschool , Female , Humans , Biopsy , Melanocytes , Nevus, Spindle CellABSTRACT
This clinical and histopathological study was performed with 147 cases of benign mielanocytic tumors and 19 cases of malignant melanomas, which were obtained as surgical specimens from 1974 to 1984 at Department of Clinical Pathology, Catholic Medical College. The results were as follows: 1, In 89 cases of acquired benign melanocytic nevi, the average age of intradermal type(64 cases) was 34. 7 years and that of compound type(24 cases) was 24. 6 years. 2. In 30 cases of congenital nevus, nevus cells were present in the lower two thirds of reticular layer of the dermis in 93. 3% and in the subcutis as well in 3.3%. A case of giant congenital nevus with balloon cell appearance was found. 3. Of the 147 benign melanocytic tumors, a pigmented spindle cell nevus and a desmoplastic nevus were observed. 4. Blue nevi were 11 in number and excised from the face in 7, buttock in 2, shoulder in 1, upper arm in 1, and all were common type histopathologically. 5. Twelve malignant melanornas which were possible to be re-examined histopathologically were composed of 5 nodular type, 3 acral lentiginous type, 1 superficial spreading type and 3 metastatic malignant melanoma.