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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2198 - 12 November 2018 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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15M, lesion on right arm


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I always associate Spitz nevus with epithelioid melanocytes displaying abundant eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli. In other words, a Spitz nevus looks pink in low power. This nevus looks very blue at low power, the melanocytes have very little cytoplasm, and display spindle nuclei without prominent nucleoli. There are some pigment laden macrophages. Therefore, I believe it is probably better classified as pigmented spindle cell nevus of Reed. Maybe many dermatopathologists lump PSN of Reed into the category of Spitz (not quite sure Sophie Spitz would agree with that).

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Arti Bakshi

Posted

Spitz Naevus...with a more spindled than epithelioid morphology.

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Raul Perret

Posted

More in the Reed category for me. A recent article described frequent translocations involving NTRK3 in Reed nevi.

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Thank everyone for the insightful discussion. This is a Spitz nevus with features of PSN of Reed. 

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