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.

General

  • Uncommon.
  • Women in teens & 20s.

Gross

  • Location: shoulder, pelvic girdle region.

Microscopic

Features:[1]

  • Nests of heavily pigmented spindle cells at dermal-epidermal junction - key feature.
    • Nevoid cells in epidermis & dermis - form "basket weave" pattern
  • Well-circumscribed lesion.

Notes:

  • No epithelioid nevus cells.

DDx:

Images

www:

IHC

Features:[2]

  • Cyclin D1 ~12% of cells (range 1-40) vs. ~42% of cells (range 1-95%).
  • Ki-67 ~1% of cells (range 0-5) vs. ~13% (range 1-40).

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SKIN LESION, RIGHT POSTERIOR NECK, EXCISION:
- PIGMENTED SPINDLE CELL NEVUS OF REED.
-- COMPLETELY EXCISED (CLEARANCE ~ 1 MM).

Micro

The sections show spindled pigmented melanocytes in nests confined to the epidermis. The lesion is symmetrical in its architecture and pigment distribution. There is no pagetoid spread of melanocytes in the epidermis. No significant nuclear atypia is identified. No mitotic activity is appreciated. Melanophages are present in the superficial dermis. The lesion is completely excised in the plane of section.

See also

References

  1. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 500. ISBN 978-0781765275.
  2. Díaz, A.; Valera, A.; Carrera, C.; Hakim, S.; Aguilera, P.; García, A.; Palou, J.; Puig, S. et al. (Nov 2011). "Pigmented spindle cell nevus: clues for differentiating it from spindle cell malignant melanoma. A comprehensive survey including clinicopathologic, immunohistochemical, and FISH studies.". Am J Surg Pathol 35 (11): 1733-42. doi:10.1097/PAS.0b013e318229cf66. PMID 21997694.