Spitz naevus

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Described by Sophie Spitz.[1]

A benign form of melanocytic naevus that is more common in children and young adults. The term benign juvenile melanoma is deprecated. The naevi tend to occur on the head, neck, trunk and extremeties. The lesion are frequently pink, dome-shaped nodules measuring no more than

The histological appearences can mimic a malignant melanoma. It may be difficult ot separate Spitz naevi with atypical features from malignant melanoma and wider excision and close follow-up is advised in cases of diagnostic doubt. The diagnosis of Spitz in older adults is unusual (melanoma is more likely) with the exception of one the desmoplastic variant.

Histological Features

  • Most are compound, 20% intra-dermal and 5-10% junctional
  • The junctional nests may be vertically oriented
  • Epitheloid and/or spindle-like cells, often with large cells showing marked nuclear and cytoplasmic pleomorphism
  • Symmetry
  • Preserved maturation
  • Pagetoid spread is usually absent, although the earliest stages of Spitz naevi are intra-dermal and are also known as Pagetoid Spitz naevi. However, the naevus cells are confined to the lower layers.
  • Kamino bodies