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Plexiform spindle cell naevus: a distinctive variant of plexiform melanocytic naevus
R L Barnhill1, M C Mihm, C M Magro
1Department of Pathology, Massachusetts General Hospital, Boston 02114.
Histopathology
|March 1, 1991
Summary
A unique plexiform spindle cell nevus, affecting young adults, presents distinct histological features. This benign melanocytic nevus is characterized by its plexiform architecture and spindle cells with granular melanin.
Area of Science:
- Dermatopathology
- Oncology
- Histology
Background:
- Melanocytic nevi are common skin lesions.
- Spindle cell nevi and blue nevi are specific types with distinct histological features.
- A unique variant, plexiform spindle cell nevus, requires clear definition and differentiation.
Purpose of the Study:
- To describe a unique type of melanocytic nevus termed plexiform spindle cell nevus.
- To outline its clinical and histological characteristics.
- To establish its differential diagnosis from similar entities.
Main Methods:
- Case series analysis of twelve patients with plexiform spindle cell nevus.
- Clinical and histological examination of lesion morphology.
- Immunohistochemical analysis (S-100, HMB-45) in select cases.
Main Results:
- Lesions occurred in young individuals (mean age 22.5 years) on the shoulders and back.
- Histology showed a wedge-shaped configuration with spindle cells in fascicles and a plexiform architecture.
- Low-grade cellular atypia was common; S-100 and HMB-45 were positive in two cases.
Conclusions:
- Plexiform spindle cell nevus is a distinctive benign melanocytic proliferation.
- Its unique plexiform architecture and predominant spindle cells differentiate it from Spitz nevi and blue nevi.
- Accurate histological differentiation is crucial to exclude melanoma.