Pigmented spindle cell nevus

Pigmented Spindle Cell Nevus

File:Pigmented Spindle Cell Nevus.jpg

Pigmented Spindle Cell Nevus

Pigmented spindle cell nevus, also known as pigmented spindle cell melanocytic proliferation, is a benign skin lesion that primarily affects children and young adults. It is characterized by the presence of pigmented spindle-shaped cells in the dermis. This article aims to provide a detailed overview of pigmented spindle cell nevus, including its clinical features, histopathology, differential diagnosis, and management.

Clinical Features

Pigmented spindle cell nevus typically presents as a solitary, well-circumscribed, pigmented or hyperpigmented macule or papule on the skin. It commonly occurs on the extremities, particularly the lower limbs. The lesion may range in size from a few millimeters to several centimeters. Pigmented spindle cell nevi are usually asymptomatic and do not cause any discomfort or itching.

Histopathology

Histopathologically, pigmented spindle cell nevus is characterized by the presence of elongated, spindle-shaped melanocytes within the dermis. These cells are arranged in fascicles or storiform patterns. The melanocytes exhibit mild to moderate cytologic atypia, with elongated nuclei and dispersed chromatin. Pigmented spindle cell nevi also show variable pigmentation, ranging from lightly pigmented to heavily pigmented cells. The overlying epidermis is usually unremarkable, without any significant changes.

Differential Diagnosis

Pigmented spindle cell nevus can resemble other pigmented skin lesions, making its diagnosis challenging. The main differential diagnoses include:

- Spitz nevus: Spitz nevus shares some histopathological features with pigmented spindle cell nevus, such as spindle-shaped melanocytes. However, Spitz nevus typically occurs in younger individuals and exhibits more significant cytologic atypia and architectural disarray compared to pigmented spindle cell nevus.

- Atypical Spitz tumor: Atypical Spitz tumor is a variant of Spitz nevus that displays more pronounced cytologic atypia and architectural disarray. Distinguishing atypical Spitz tumor from pigmented spindle cell nevus can be challenging and often requires additional molecular testing.

- Melanoma: Melanoma is a malignant skin tumor that can mimic pigmented spindle cell nevus clinically and histopathologically. Careful evaluation of cytologic atypia, architectural features, and additional immunohistochemical stains can help differentiate melanoma from pigmented spindle cell nevus.

Management

Pigmented spindle cell nevus is a benign lesion that does not require any specific treatment. However, excisional biopsy may be performed for diagnostic purposes or if the lesion is cosmetically bothersome to the patient. Complete excision with clear margins is curative, and recurrence is rare.

Conclusion

Pigmented spindle cell nevus is a benign skin lesion characterized by the presence of pigmented spindle-shaped cells in the dermis. It primarily affects children and young adults and typically presents as a solitary, pigmented macule or papule on the extremities. Histopathological examination is essential for accurate diagnosis, as pigmented spindle cell nevus can resemble other pigmented skin lesions, including Spitz nevus and melanoma. Management involves observation or excisional biopsy if necessary. Overall, pigmented spindle cell nevus has an excellent prognosis, with rare recurrence.

Pigmented spindle cell nevus Resources
Need Help Finding a Doctor? Need help finding a doctor or specialist anywhere in the world? Explore our world directory. WikiMD's DocFinder can assist you in locating millions of physicians.	Medical Knowledge Access the latest research - Most recent articles Ongoing trials.

Translate to: East Asian 中文, 日本, 한국어, South Asian हिन्दी, Urdu, বাংলা, తెలుగు, தமிழ், ಕನ್ನಡ,
Southeast Asian Indonesian, Vietnamese, Thai, မြန်မာဘာသာ, European español, Deutsch, français, русский, português do Brasil, Italian, polski