Elsevier

Human Pathology

Volume 29, Issue 10, October 1998, Pages 1105-1112
Human Pathology

Original contribution
Spitz nevus versus spitzoid malignant melanoma: An evaluation of the current distinguishing histopathologic criteria

https://doi.org/10.1016/S0046-8177(98)90421-XGet rights and content

Abstract

Because of the well-known difficulty in distinguishing between Spitz nevi and spitzoid malignant melanomas at the microscopic level, the critical importance of this task notwithstanding, expert dermato pathologists across the world have strenuously endeavored to identify histopathologic criteria that would assist microscopists in this effort. Many reports itemizing such criteria are extant. The objective of the current study was to determine which of these criteria serve as the most consistent discriminators. Using a population of 11 spitzoid melanomas and 12 Spitz nevi, we evaulated six sets of criteria purported to be helpful in differentiating between these entities. Overall, we found that six features had significant distinguishing capacity, namely, (1) Kamino bodies, (2) a brisk mitotic rate, (3) mitoses close to the base of the lesion, (4) abnormal mitoses, (5) symmetry, and (6) uniformity of nests from side to side. It is noteworthy that the first three of these rank among the six criteria itemized repeatedly in 50% or more of the sets of criteria evaluated.

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    This work was undertaken by Dr Walsh during a sabbatical at the Royal Prince Alfred Hospital and the University of Sydney from Jan to July 1997.

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    Copyright © 1998 W. B. Saunders Company. All rights reserved. Published by Elsevier Inc. All rights reserved.