Case Number : Case 554 - 24 July Posted By: Guest

[b]Compound spitz nevus, incompletely excised.[/b]

Compound Spitz naevus.

Agree, Spitz nevus.

Agree with compound Spitz naevus

There is one mitosis in the right lower microphotograph, though I think this is a compound Spitz I would suggest a re-excision

I agree, compound spitz nevus and if the mitosis is located in the deep part i recommended a reexcision

Part of a compound Spitz naevus.

Spitz' nevus, compound type

Compound spitz, incompletely excised.

[color=#000000]Provisionally a [b]Spitz naevus[/b]. Incomplete biopsy, [b]incomplete biopsy[/b] of melanocytic lesions can impair the accuracy of the pathological diagnosis. [b]Cell type[/b], [b]junctional cleavage[/b] (separation of the epidermis from nests of naevus cells at the junctional zone) are to be noted; need to search for eosinophilic globules ([b]Kamino bodies[/b]) most commonly seen in the basal cell layer above the tips of dermal papillae, if any, in multiple sections (also a stain like trichrome stain maybe needed); need to search for mitoses if any in the deeper portion of the lesion. [/color][color=#231F20]Comparative genomic hybridization ([b]CGH[/b])[/color] [color=#231F20]has been used to show differences between Spitz[/color] [color=#231F20]naevi and melanomas and has proved to have [/color][color=#000000]excellent discriminatory value. As always, [b]clinicopathological correlation[/b] is vital. [/color]

I agree that this is a Spitz nevus. The problem however is that we are not able to visualize the whole lesion. This happens so often and I find it so frustrating. If the dermatologist is concerned enough about a Spitz nevus, he/she should excise the lesion in toto rather than sending a punch biopsy or worse still a shave biopsy. I too have to advise a re-excision to assess what is left of the lesion as the features determining maignant potential may be at the base (and un-sampled) part of the lesion.