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Difference between revisions of "Pigmented spindle cell nevus"
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'''Pigmented spindle cell nevus''', also '''pigmented spindle cell nevus of Reed''', is an uncommon benign [[melanocytic lesion]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Pigmented_spindle_cell_nevus_-_2_-_high_mag.jpg | |||
| Width = | |||
| Caption = Pigmented spindle cell nevus. [[H&E stain]]. | |||
| Synonyms = Pigmented spindle cell nevus of Reed, Reed nevus | |||
| Micro = nests of heavily pigmented spindle cells at dermal-epidermal junction, no epithelioid cells | |||
| Subtypes = | |||
| LMDDx = [[malignant melanoma]], [[Spitz nevus]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = dark brown/back, usu. 3-6 mm | |||
| Grossing = | |||
| Site = [[skin]] - usu. lower extremity, back, shoulder | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = classically women - teens and 20s | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = good | |||
| Other = | |||
| ClinDDx = other [[melanocytic lesions]] | |||
| Tx = | |||
}} | |||
'''Pigmented spindle cell nevus''', also '''pigmented spindle cell nevus of Reed''' and '''Reed nevus''',<ref name=pmid21997694/> is an uncommon benign [[melanocytic lesion]]. | |||
==General== | ==General== | ||
*Benign. | |||
*Uncommon. | *Uncommon. | ||
*Women | *Women (M:F = 1:1.4<ref name=pmid8463457/>). | ||
*Usually 20s or teens. | |||
Note: | |||
*It was previously considered a variant of [[Spitz nevus]].<ref name=pmid21605093>{{cite journal |author=Webber SA, Siller G, Soyer HP |title=Pigmented spindle cell naevus of Reed: a controversial diagnostic entity in Australia |journal=Australas. J. Dermatol. |volume=52 |issue=2 |pages=104–8 |year=2011 |month=May |pmid=21605093 |doi=10.1111/j.1440-0960.2011.00743.x |url=}}</ref> | |||
==Gross== | ==Gross== | ||
*Location: | Features:<ref name=pmid8463457>{{Cite journal | last1 = Sau | first1 = P. | last2 = Graham | first2 = JH. | last3 = Helwig | first3 = EB. | title = Pigmented spindle cell nevus: a clinicopathologic analysis of ninety-five cases. | journal = J Am Acad Dermatol | volume = 28 | issue = 4 | pages = 565-71 | month = Apr | year = 1993 | doi = | PMID = 8463457 }}</ref> | ||
*Dark brown/black. | |||
*Typically 3-6 mm. | |||
**Mostly under 7 mm.<ref name=pmid21997694/> | |||
Location: | |||
*Usually extremities (75% in one series<ref name=pmid8463457/>) - typically lower extremities. | |||
*Back. | |||
*Shoulder region. | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=Ref_WMSP500>{{Ref WMSP|500}}</ref> | Features:<ref name=Ref_WMSP500>{{Ref WMSP|500}}</ref> | ||
*Nests of heavily pigmented spindle cells at dermal-epidermal junction - '''key feature'''. | *Nests of heavily pigmented spindle cells at dermal-epidermal junction - '''key feature'''. | ||
**Nevoid cells in epidermis & dermis - form "basket weave" pattern | **Nevoid cells in epidermis & dermis - form "basket weave" pattern. | ||
*Well-circumscribed lesion. | *Well-circumscribed lesion. | ||
| Line 32: | Line 75: | ||
==IHC== | ==IHC== | ||
Features:<ref name=pmid21997694>{{Cite journal | last1 = Díaz | first1 = A. | last2 = Valera | first2 = A. | last3 = Carrera | first3 = C. | last4 = Hakim | first4 = S. | last5 = Aguilera | first5 = P. | last6 = García | first6 = A. | last7 = Palou | first7 = J. | last8 = Puig | first8 = S. | last9 = Malvehy | first9 = J. | title = Pigmented spindle cell nevus: clues for differentiating it from spindle cell malignant melanoma. A comprehensive survey including clinicopathologic, immunohistochemical, and FISH studies. | journal = Am J Surg Pathol | volume = 35 | issue = 11 | pages = 1733-42 | month = Nov | year = 2011 | doi = 10.1097/PAS.0b013e318229cf66 | PMID = 21997694 }}</ref> | Features:<ref name=pmid21997694>{{Cite journal | last1 = Díaz | first1 = A. | last2 = Valera | first2 = A. | last3 = Carrera | first3 = C. | last4 = Hakim | first4 = S. | last5 = Aguilera | first5 = P. | last6 = García | first6 = A. | last7 = Palou | first7 = J. | last8 = Puig | first8 = S. | last9 = Malvehy | first9 = J. | title = Pigmented spindle cell nevus: clues for differentiating it from spindle cell malignant melanoma. A comprehensive survey including clinicopathologic, immunohistochemical, and FISH studies. | journal = Am J Surg Pathol | volume = 35 | issue = 11 | pages = 1733-42 | month = Nov | year = 2011 | doi = 10.1097/PAS.0b013e318229cf66 | PMID = 21997694 }}</ref> | ||
*Cyclin D1 ~12% of cells (range 1-40%) vs. ~42% of cells (range 1-95%). | *Cyclin D1 ~12% of cells (range 1-40%) vs. ~42% of cells (range 1-95%) in melanoma. | ||
*Ki-67 ~1% of cells (range 0-5%) vs. ~13% (range 1-40%). | *Ki-67 ~1% of cells (range 0-5%) vs. ~13% (range 1-40%) in melanoma. | ||
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