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

Spitz Nevus

Agree. Spitz Nevus for me too. 

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).

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

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

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