Adult Spitz Nevus

Deba P Sarma, MD
Omaha
F 27, left leg, 4 mm 'mole'
 Comment
-The lesion is small (4mm), symmetrical, slightly raised and focally pigmented.
-It is composed of junctional nested proliferation of moderately pleomorphic
epitheliod nevocytes extending into the papillary dermis and gradually
maturing into small bland nevus cell nests in deeper dermis.
-The overlying epidermis is intact and free of ulceration and it shows a few
pagetoid melanocytic cells with bland nuclei.
-The junctional epitheliod nevocytes show large amount of cytoplasm with
mostly large bland nuclei. Some cells show dark nuclei with prominent
nucleoli.
-A few normal mitotic figures are seen in the superficial epitheliod part of the
lesion, none in the deeper dermis.
-No atypical mitosis or cell necrosis is present.
-There is a mild chronic inflammatory cell infiltration in the dermis.
-Overall picture is that of an epitheliod compound nevus ( adult Spitz nevus).
There is no diagnostic feature of melanoma.
In a 27-year-old female patient with an adult Spitz nevus of leg, a conservative
re-excision of the previous biopsy site should be considered.