Histopathology of Spitz Naevi and “Spitzoid” Melanomas

Wj, Mooi

doi:10.1007/978-3-642-59552-3_4

Cited by 19 publications

(14 citation statements)

References 53 publications

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“…20 Other authors have cited similar criteria, as well as other criteria, for the diagnosis of Spitz-like melanoma, such as marked pagetoid spread, 26 singlecell epidermal invasion below parakeratosis, 27 asymmetry, 5 destruction of collagen, 3 substantial and/or deep melanization, 21 and variability of cellular features between adjacent cell groups. 4 Reed proposed that confluent or expansile, nodular aggregates of atypical Spitz-like cells in the dermis represent a vertical growth phase or possess a competence for metastasis and are regarded best as minimal deviation melanoma, Spitz-like type. 9 Dermatopathologists generally agree that no single histologic finding is diagnostic in and of itself for Spitz nevus or Spitz-like melanoma.…”

Section: Discussionmentioning

confidence: 99%

“…2 Although most spindle and epithelioid melanocytic proliferations readily are classifiable histologically as Spitz nevus or melanoma with Spitz-like features, 1,[3][4][5] there is a subset of problematic and diagnostically challenging melanocytic lesions variably designated as atypical Spitz tumor, atypical Spitz nevus, Spitz-like lesion in the borderline category of indeterminate malignant potential, and diagnostically controversial spitzoid melanocytic tumors, that defy classification into either category even by the most experienced dermatopathologists. 2,6 -10 These lesions simultaneously exhibit some histomorphologic features of classic Spitz nevus and Spitz-like melanoma, making diagnostic assignment to either Spitz nevus or Spitz-like melanoma difficult, controversial, and sometimes erroneous.…”

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confidence: 99%

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Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Fullen

Sondak

et al. 2003

Cancer

146

122

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A new device—the rotational particle separator (RPS)—is compared to the cyclone for the removal of ultrafine particles, such as cryogenically condensed contaminant droplets from natural gas. The comparison focusses on identifying for each configuration the smallest size of particle which has a 50% chance of being removed from the gas stream. Whereas a cyclone can only separate 1 μm droplets at very low‐throughputs on the order of 1 MMscfd, at the same energy consumption and device volume, the rotational particle separator removes droplets of that size at throughputs of 300 MMscfd. The advantage of the rotational particle separator, therefore, lies in its compact separation potential for full‐scale industrial gas well throughputs. © 2006 American Institute of Chemical Engineers AIChE J, 2007

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Fullen

Sondak

et al. 2003

Cancer

146

122

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“…The most useful histopathologic criteria for differentiating nodular melanoma from Spitz nevi are (1) lack of dermal maturation, (2) deep dermal mitoses, (3) numerous dermal mitoses, (4) atypical dermal mitoses, and (5) abundant and lateral pagetoid ascension. [64][65][66] Although superficial spreading melanoma is considered the most frequent type of melanoma in adults, conclusive data on histologic classification of pediatric melanoma are lacking. Only a few case series have included histologic classification.…”

Section: Discussionmentioning

confidence: 99%

Malignant melanoma in childhood and adolescence: Report of 13 cases

Jafarian¹,

Powell²,

Kokta

et al. 2005

Journal of the American Academy of Dermatology

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“…Spitz nevus can cause major problems in diagnosis at any site, even when clinical awareness may suggest the diagnosis [61]. While tumors that display all or most of the typical features of a Spitz nevus should be appropriately diagnosed, it is recognized that it can be very difficult or impossible even for experts to predict the biologic behavior of some Spitzoid melanocytic tumors with atypical pathologic features [62][63][64].…”

Section: Difficult and Controversial Issues Affecting Surgeons And Pamentioning

confidence: 98%

Pathology of melanocytic lesions: New, controversial, and clinically important issues

Scolyer

Thompson

Stretch

et al. 2004

Journal of Surgical Oncology

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Patients with primary cutaneous melanocytic lesions rely not only on the knowledge, skills, and experience of their treating clinician but also on the fundamentally important input of their pathologist for accurate diagnosis and appropriate management. Free and precise communication between pathologists and surgeons is important and undoubtedly improves patient care, particularly when managing difficult or complicated cases. To provide both patient and surgeon with the necessary information they require to make the most appropriate decisions, the pathology report should include all pathologic factors that are important in determining the patient's prognosis and management. Use of a synoptic format for pathology reporting of melanomas can facilitate this. Recent studies have established that the dermal mitotic rate of a primary cutaneous melanoma is a major prognostic determinant, and have shown that its assessment and that of other important histopathologic prognostic variables are reproducible between pathologists. Sentinel node (SN) biopsy has provided a minimally invasive procedure that can accurately predict the regional node status of melanoma patients. It is well demonstrated that the use of immunohistochemical stains assists in the detection of melanoma micrometastases in SNs, although it remains unclear which is the optimal pathologic protocol for SN evaluation and whether there is a role for reverse transcriptase polymerase chain reaction (RT-PCR) in SN assessment. False negative SN biopsies may occur as a result of errors in lymphatic mapping or sentinel lymphadenectomy, or because of a deficiency in the process of histopathologic evaluation. Recent studies have shown that the likelihood of non-SN involvement when the SN is positive correlates mostly with the extent of SN involvement, in particular the tumor penetrative depth (defined as the maximum distance of melanoma cells from the inner margin of the SN capsule). It appears that assessment of the micromorphometric features of positive SNs may be useful in predicting which patients have a low probability of having metastatic tumor in non-SNs, and therefore in selecting patients who potentially may be spared a completion lymph node dissection. It is likely that future advances in our understanding of the molecular biology of melanoma will provide new insights into tumor classification, improve diagnostic accuracy and prognostic ability, and lead to the development of more precisely targeted therapies.

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Histopathology of Spitz Naevi and “Spitzoid” Melanomas

Cited by 19 publications

References 53 publications

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Malignant melanoma in childhood and adolescence: Report of 13 cases

Pathology of melanocytic lesions: New, controversial, and clinically important issues

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