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1. Murakami M, Wada T, Kashiwagi T, Ishida-Yamamoto A, Iizuka H: Nodular malignant melanoma with Spitz nevus-like pathological features finally confirmed by the pathological feature of the sentinel lymph node. J Dermatol; 2007 Dec;34(12):821-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nodular malignant melanoma with Spitz nevus-like pathological features finally confirmed by the pathological feature of the sentinel lymph node.
  • The clinical and histopathological similarities of nodular melanoma and Spitz nevus currently still make a definitive diagnosis difficult.
  • We report here a case of nodular melanoma that was extremely difficult to diagnose both clinically and histopathologically.
  • The primary tumor was a blackish nodule on the scalp and biopsy was performed for pathological diagnosis.
  • Although our first impression was malignant melanoma, we asked two dermatopathologists for second opinions; however, one diagnosed a melanoma and the other a Spitz nevus.
  • Histopathological diagnosis to establish whether it was a melanoma metastasis or nodal nevi was also difficult, and we again asked for second opinions from another dermatopathologist in the USA.
  • According to its clinical course and the histopathology of the sentinel lymph node with additional immunohistochemistry, this case was finally diagnosed as a nodular melanoma (T4aN1aM0, stage IIIA).
  • [MeSH-major] Head and Neck Neoplasms / pathology. Melanoma / pathology. Scalp. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Humans. Male. Nevus, Epithelioid and Spindle Cell / pathology. Sentinel Lymph Node Biopsy


2. Tetzlaff MT, Xu X, Elder DE, Elenitsas R: Angiomatoid Spitz nevus: a clinicopathological study of six cases and a review of the literature. J Cutan Pathol; 2009 Apr;36(4):471-6
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  • [Title] Angiomatoid Spitz nevus: a clinicopathological study of six cases and a review of the literature.
  • Angiomatoid Spitz nevus is a recently described subtype of desmoplastic Spitz nevus.
  • Here, we describe six additional cases of angiomatoid Spitz nevus and provide a review of the literature on this entity.
  • The features of classic angiomatoid Spitz nevus are described in the context of important differential diagnostic considerations, particularly regressed malignant melanoma.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Child. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Male. Melanoma / pathology

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  • (PMID = 19278435.001).
  • [ISSN] 1600-0560
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Denmark
  • [Number-of-references] 13
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3. Haenssle HA, Kaune KM, Buhl T, Thoms KM, Padeken M, Mitteldorf C, Emmert S: Large speckled lentiginous naevus superimposed with Spitz naevi: sequential digital dermoscopy may lead to unnecessary excisions triggered by dynamic changes. Clin Exp Dermatol; 2009 Mar;34(2):212-5
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  • [Title] Large speckled lentiginous naevus superimposed with Spitz naevi: sequential digital dermoscopy may lead to unnecessary excisions triggered by dynamic changes.
  • We report a 14-year-old girl with a large speckled lentiginous naevus (SLN) on her left arm and shoulder.
  • As the occurrence of melanoma within SLN has been described previously, long-term follow-up of atypical lesions by digital dermoscopy was started at the age of 4 years.
  • To date, nine Spitz naevi and four dysplastic compound naevi have been excised due to dynamic changes over time.
  • No melanoma has so far been detected.
  • We critically discuss the possibility of an 'overtreatment' because of a high rate of physiological changes within SLN of children.
  • In order to avoid unnecessary excisions triggered by subtle dynamic changes, a standard approach with overview images, conventional dermoscopy and early excision of lesions that are rated as suspicious for melanoma by established algorithms may be recommended.
  • [MeSH-major] Dermoscopy / methods. Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Disease Progression. Early Detection of Cancer. Female. Humans. Unnecessary Procedures

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  • [CommentIn] Clin Exp Dermatol. 2009 Mar;34(2):133-5 [19040513.001]
  • (PMID = 19040514.001).
  • [ISSN] 1365-2230
  • [Journal-full-title] Clinical and experimental dermatology
  • [ISO-abbreviation] Clin. Exp. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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4. Kawasaki K, Kawakami T, Watabe H, Itoh F, Mizoguchi M, Soma Y: Expression of matrilysin (matrix metalloproteinase-7) in primary cutaneous and metastatic melanoma. Br J Dermatol; 2007 Apr;156(4):613-9
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  • [Title] Expression of matrilysin (matrix metalloproteinase-7) in primary cutaneous and metastatic melanoma.
  • BACKGROUND: Matrilysin (MMP-7), a member of the matrix metalloproteinase (MMP) family of proteins, is expressed in various types of malignant tumours.
  • There have been no previous studies of the correlation between matrilysin expression and melanoma.
  • OBJECTIVES: Protein expression of matrilysin was evaluated in human cutaneous melanomas, metastatic melanomas, acquired common melanocytic naevi and Spitz naevi, and the data were corrected with the clinicopathological factors.
  • METHODS: We retrospectively investigated 18 primary melanomas, 15 metastatic melanomas, 10 common melanocytic naevi and five Spitz naevi samples at our clinic using immunohistochemistry (IHC).
  • Both promatrilysin and active matrilysin were found in the melanoma tissue extracts by Western immunoblotting.
  • In situ hybridization demonstrated that melanoma cells selectively express matrilysin mRNA.
  • RESULTS: Of the melanoma samples, 29 of 33 (87 x 9%) were positive for matrilysin, including 14 of 18 (77 x 8%) primary cutaneous melanomas and 15 of 15 (100%) metastatic melanomas.
  • In contrast, matrilysin was not expressed in common naevi or Spitz naevi.
  • The matrilysin IHC staining score in primary melanomas was associated with the presence of metastases, tumour thickness and TNM staging (P=0 x 001, 0 x 025 and 0 x 021, respectively).
  • The 5-year overall survival was 26.3% for matrilysin-positive cases and 100% for matrilysin-negative cases among melanoma specimen.
  • CONCLUSIONS: We found matrilysin expression in primary melanomas and in metastatic melanomas.
  • We further demonstrated that the matrilysin IHC staining score was associated with invasive depth of primary melanoma lesions and metastases.
  • Our observations indicate that matrilysin may be associated with melanoma progression, and may enhance melanoma tumour cell invasion.
  • Therefore, matrilysin may be potentially valuable as a prognostic indicator to predict the clinical behaviour of melanoma.
  • [MeSH-major] Enzyme Precursors / analysis. Matrix Metalloproteinase 7 / analysis. Melanoma / chemistry. Metalloendopeptidases / analysis. Neoplasm Proteins / analysis. Skin Neoplasms / chemistry

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  • (PMID = 17493064.001).
  • [ISSN] 0007-0963
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Enzyme Precursors; 0 / Neoplasm Proteins; EC 3.4.24.- / Metalloendopeptidases; EC 3.4.24.- / promatrilysin; EC 3.4.24.23 / Matrix Metalloproteinase 7
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5. Roaten JB, Partrick DA, Bensard D, Pearlman N, Gonzalez R, Fitzpatrick J, McCarter MD: Survival in sentinel lymph node-positive pediatric melanoma. J Pediatr Surg; 2005 Jun;40(6):988-92; discussion 992
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  • [Title] Survival in sentinel lymph node-positive pediatric melanoma.
  • BACKGROUND: Sentinel lymph node (SLN) status is the strongest predictor of survival in adult melanoma.
  • However, the prognostic value of SLN status in children and adolescents with melanoma is unknown.
  • METHODS: Records of 327 patients aged 12 to 86 years undergoing SLN biopsy for melanoma or other melanocytic lesions were reviewed.
  • Of the 55 adults, 5 (9.1%) have died of disease.
  • Sentinel lymph node status does not predict early recurrence in pediatric patients with melanoma or atypical Spitz nevi.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Sentinel Lymph Node Biopsy. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Age Factors. Aged. Aged, 80 and over. Child. Disease-Free Survival. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Retrospective Studies

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  • (PMID = 15991183.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Meta-Analysis
  • [Publication-country] United States
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6. Vetter CS, Müller-Blech K, Schrama D, Bröcker EB, Becker JC: Cytoplasmic and nuclear expression of survivin in melanocytic skin lesions. Arch Dermatol Res; 2005 Jul;297(1):26-30
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  • Survivin, a member of the inhibitors of apoptosis protein family, regulates both cellular proliferation and apoptotic cell death.
  • While the human survivin gene is highly expressed in the developing fetus, in adults its expression is restricted to highly proliferating normal tissues and neoplastic tumors tissues.
  • In the present study, we compared the expression of survivin in melanoma and benign melanocytic lesions such as junctional, compound, dermal, congenital, blue and spitz nevi.
  • In junctional, compound and blue nevi, survivin was present in nuclear localization, whereas in spitz nevi survivin was detectable in the cytoplasm.
  • In dermal and congenital nevi, survivin was present in both localizations with predominance of the nuclear compartment.
  • Interestingly, this distribution was similar to that observed in primary melanoma; whereas in metastatic melanoma the predominance of the nuclear localization of survivin was lost.
  • Our data demonstrate that although survivin is expressed in a large number of benign nevi, the balance between its cytoplasmic and nuclear expression was immensely heterogeneous between lesions with suspected different developmental origins.
  • [MeSH-major] Cell Nucleus / chemistry. Cytoplasm / chemistry. Melanoma / chemistry. Microtubule-Associated Proteins / analysis. Neoplasm Proteins / analysis. Nevus / chemistry. Skin Neoplasms / chemistry

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  • (PMID = 15906050.001).
  • [ISSN] 0340-3696
  • [Journal-full-title] Archives of dermatological research
  • [ISO-abbreviation] Arch. Dermatol. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins; 0 / Neoplasm Proteins
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7. Lommatzsch PK, Willerding G, Nenning H, Taubert G: [Inflammatory juvenile conjunctival nevus (IJCN)]. Klin Monbl Augenheilkd; 2007 May;224(5):422-6
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  • [Title] [Inflammatory juvenile conjunctival nevus (IJCN)].
  • BACKGROUND: Pathologists may occasionally have difficulties in reliably assessing the dignity of tumour cells in histological sections, especially in nevi with junctional activity.
  • PATIENT HISTORY: This case history of a boy suffering from an inflammatory juvenile conjunctival nevus (IJCN) is reported with a follow-up period of 25 years.
  • Seven years after first surgical treatment of a histologically proven nevus, a recurrent pigmented lesion within the former operation area aroused the suspicion of it being a malignant melanoma.
  • The histological diagnosis performed by a pathologist resulted in a malignant melanoma.
  • A second recurrent pigmented conjunctival tumour developed fourteen years later.
  • This lesion again aroused another strong clinical suspicion of malignant transformation into a melanoma.
  • However, the histological examination of the biopsy at this time only showed benign nevus cells and areas of conjunctival melanosis without atypia.
  • DISCUSSION: Especially in young patients, IJCN must be regarded as an independent type of nevus, which might lead even experts in ophthalmic pathology to over-diagnose this lesion as a malignant melanoma.
  • A reappraisal of the former histological specimens of the first recurrent tumour by other pathologists came to the conclusion that the initial diagnosis of melanoma could not be maintained.
  • Nevertheless, we also strongly recommend follow-up examinations at regular intervals in cases of IJCN since we are aware of the fact that melanocytic tumours of the conjunctiva behave unpredictably.
  • [MeSH-major] Conjunctival Diseases / diagnosis. Conjunctival Neoplasms / diagnosis. Melanoma / diagnosis. Nevus, Pigmented / diagnosis

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  • (PMID = 17516373.001).
  • [ISSN] 0023-2165
  • [Journal-full-title] Klinische Monatsblätter für Augenheilkunde
  • [ISO-abbreviation] Klin Monbl Augenheilkd
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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8. Wick MR, Patterson JW: Cutaneous melanocytic lesions: selected problem areas. Am J Clin Pathol; 2005 Dec;124 Suppl:S52-83
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  • This review considers several selected issues in that subject area, including proliferative congenital nevi, architecturally disordered (dysplastic) nevi, morphologic variants of Spitz nevus, atypical lentiginous melanocytic proliferations, nevoid melanoma, diagnostically deceptive histologic variants of melanoma, "epidermotropic" metastases of melanoma, and the relationship of melanoma microstages to tumor growth phases.
  • [MeSH-major] Melanoma / pathology. Nevus / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Cell Proliferation. Dysplastic Nevus Syndrome / pathology. Humans. Lentigo / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Nevus, Pigmented / pathology

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  • (PMID = 16468418.001).
  • [ISSN] 0002-9173
  • [Journal-full-title] American journal of clinical pathology
  • [ISO-abbreviation] Am. J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 222
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9. Bron JL, Jaspars EH, Molenkamp BG, Meijer S, Mooi WJ, van Leeuwen PA: [Three patients with a Spitz naevus that later turned out to be a melanoma]. Ned Tijdschr Geneeskd; 2005 Aug 13;149(33):1852-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Three patients with a Spitz naevus that later turned out to be a melanoma].
  • [Transliterated title] Drie patiënten met op Spitz-naevus gelijkende afwijkingen die later een melanoom bleken te zijn.
  • The preferred diagnosis was 'Spitz naevus'.
  • Subsequently, all three developed regional (sub)cutaneous and/or lymph node metastases, indicating that the lesions were melanomas.
  • The histopathological distinction between Spitz naevus and melanoma is often very difficult.
  • Classical Spitz naevi can be diagnosed correctly only if the entire lesion is available for histological examination.
  • Some melanomas resemble Spitz naevi, but can be recognised on the basis of well-defined histological indicators of malignancy.
  • Some melanocytic lesions, however, cannot be categorised with confidence as being either benign (Spitz naevus) or malignant (spitzoid melanoma).
  • Thus, a group of lesions with inconclusive histology remains and has been designated as 'atypical Spitz tumour' or 'Spitz tumour of uncertain malignant potential'.
  • Generally, such lesions are best treated as melanomas.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 16128184.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Netherlands
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10. Requena C, Requena L, Sánchez-Yus E, Nagore E, Alfaro A, Llombart B, Botella R, Sanmartín O, Guillén C: Pigmented epithelioid Spitz naevus: report of two cases. Histopathology; 2006 Nov;49(5):549-51
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  • [Title] Pigmented epithelioid Spitz naevus: report of two cases.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 17064308.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] England
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11. Emley A, Yang S, Wajapeyee N, Green MR, Mahalingam M: Oncogenic BRAF and the tumor suppressor IGFBP7 in the genesis of atypical spitzoid nevomelanocytic proliferations. J Cutan Pathol; 2010 Mar;37(3):344-9
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  • [Title] Oncogenic BRAF and the tumor suppressor IGFBP7 in the genesis of atypical spitzoid nevomelanocytic proliferations.
  • Rare reports indicate that the frequency of BRAFV600E mutations is high in atypical Spitz nevi.
  • The purpose of this study was to ascertain the utility of the RAF/RAS mutational status as a diagnostic adjunct in lesions with histologic features that deviate from a typical Spitz nevus and, to examine expression of Insulin growth factor binding protein 7 (IGFBP7), a tumor suppressor acting through autocrine/paracrine pathways to inhibit BRAF-MEK-ERK signaling, in the same.
  • Genomic DNA for genotyping was isolated from 6 regular Spitz nevi and 14 atypical spitzoid nevomelanocytic proliferations (including 1 melanoma with spitzoid histomorphology).
  • A mutation in BRAFV600E was noted in only one case-that of a regular Spitz nevus.
  • Lack of expression of IGFBP7 in atypical spitzoid nevomelanocytic proliferations with histologically concerning features but BRAF-WT indicates that the evolutionary path in atypical spitzoid nevomelanocytic proliferations is genetically distinct from that of IGFBP7-negative BRAF-positive melanoma.
  • From an oncogenic BRAF perspective, our findings suggest that the majority of 'atypical' spitzoid nevomelanocytic proliferations are probably no different from conventional Spitz nevi.
  • [MeSH-major] Insulin-Like Growth Factor Binding Proteins / genetics. Nevus, Epithelioid and Spindle Cell / genetics. Proto-Oncogene Proteins B-raf / genetics. Skin Neoplasms / genetics
  • [MeSH-minor] Adolescent. Adult. Aged. Cell Proliferation. Child. Child, Preschool. Diagnosis, Differential. Female. Gene Expression Regulation, Neoplastic. Humans. Immunohistochemistry. Male. Melanoma / genetics. Melanoma / metabolism. Middle Aged. Mutation

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  • (PMID = 19788444.001).
  • [ISSN] 1600-0560
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Insulin-Like Growth Factor Binding Proteins; 0 / insulin-like growth factor binding protein-related protein 1; EC 2.7.11.1 / BRAF protein, human; EC 2.7.11.1 / Proto-Oncogene Proteins B-raf
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12. Schaffer JV: Pigmented lesions in children: when to worry. Curr Opin Pediatr; 2007 Aug;19(4):430-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pigmented lesions in children: when to worry.
  • PURPOSE OF REVIEW: Although the incidence of melanoma in adolescents and adults has risen dramatically in the past few decades, childhood melanoma remains uncommon.
  • It is therefore important for pediatricians to be aware of the natural history and clinical spectrum of melanocytic nevi in children as well as potentially worrisome features of pigmented lesions.
  • RECENT FINDINGS: Recent studies have provided insight into the development, evolution and molecular bases of acquired and congenital melanocytic nevi during childhood.
  • This review summarizes the types of melanocytic nevi that are commonly observed in children, environmental (e.g. sun exposure) and genetic (e.g. the familial atypical mole and melanoma syndrome) factors that can contribute to the development of nevi and future risk of melanoma, and phenotypic markers (e.g. numerous acquired nevi or the 'red hair phenotype') that signal the need for periodic total-body cutaneous examinations.
  • Current concepts of the risks associated with congenital melanocytic nevi of different sizes and strategies for the management of various types of nevi (including congenital, blue and Spitz nevi) are presented, and data on the clinical presentations and biologic behavior of prepubertal melanoma are discussed.
  • SUMMARY: Clinical and molecular investigations have helped to better understand the characteristics of melanocytic nevi and define pathways of melanocytic tumorigenesis.
  • [MeSH-major] Nevus, Pigmented / diagnosis
  • [MeSH-minor] Child. Diagnosis, Differential. Humans. Melanoma / diagnosis. Melanoma / genetics. Melanoma / surgery. Nevus, Blue / diagnosis. Nevus, Blue / surgery. Nevus, Epithelioid and Spindle Cell / diagnosis. Nevus, Epithelioid and Spindle Cell / surgery. Skin Neoplasms / diagnosis. Skin Neoplasms / genetics. Skin Neoplasms / surgery

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  • (PMID = 17630608.001).
  • [ISSN] 1040-8703
  • [Journal-full-title] Current opinion in pediatrics
  • [ISO-abbreviation] Curr. Opin. Pediatr.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 100
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13. Miteva M, Lazova R: Spitz nevus and atypical spitzoid neoplasm. Semin Cutan Med Surg; 2010 Sep;29(3):165-73
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  • [Title] Spitz nevus and atypical spitzoid neoplasm.
  • Spitz nevus (SN) and Spitzoid malignant melanoma (SMM) represent benign and malignant counterparts at both ends of the spectrum of Spitzoid lesions.
  • Atypical Spitzoid neoplasm (ASN) is a poorly defined and characterized category of melanocytic tumors with histologic features of both benign Spitz nevi and malignant melanomas.
  • The group of ASN represents a mixture of Spitz nevi with atypical features and Spitzoid melanomas.
  • Because this group encompasses both benign and malignant lesions, and perhaps also a separate category of melanocytic tumors that behave better than conventional melanomas, some of these neoplasms can metastasize and kill patients, whereas others have no metastatic potential, and yet others might only metastasize to regional lymph nodes.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Sentinel Lymph Node Biopsy. Skin Neoplasms / pathology


14. Blum A: [Severely dysplastic nevus: atypical Spitz nevus or melanoma in situ?]. Hautarzt; 2010 Feb;61(2):151-2
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  • [Title] [Severely dysplastic nevus: atypical Spitz nevus or melanoma in situ?].
  • [Transliterated title] Nävus mit schwerer Dysplasie, atypischer Nävus Spitz oder Melanoma in situ?
  • A 31-year-old patient presented with a new, rapidly growing pigmented skin tumor on her left thigh.
  • Several years previously a level 2 superficial spreading melanoma (SSM) with a tumor thickness of 0.45 mm had been removed from her left thigh.
  • Dermatoscopic examination revealed asymmetric pigmentation of the tumor with branched streaks of variable thickness and irregular pseudopodia.
  • Histological analysis showed it to be a severely dysplastic melanocytic nevus.
  • [MeSH-major] Dysplastic Nevus Syndrome / pathology. Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • [Cites] Arch Dermatol. 2001 Oct;137(10):1376-8 [11594873.001]
  • [Cites] J Eur Acad Dermatol Venereol. 2004 Nov;18(6):665-9 [15482291.001]
  • [Cites] Br J Dermatol. 2006 Sep;155(3):570-3 [16911283.001]
  • (PMID = 20135253.001).
  • [ISSN] 1432-1173
  • [Journal-full-title] Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete
  • [ISO-abbreviation] Hautarzt
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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15. Seehra J, Sen P, Lloyd R, Sloan P: Intraoral Spitz naevus: a case report. Int J Oral Maxillofac Surg; 2007 Jul;36(7):661-2
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  • [Title] Intraoral Spitz naevus: a case report.
  • Intraoral occurrences of Spitz naevus are very rare, there being only one previously documented case in the literature.
  • Here is reported a case of a young male who presented with a pigmented lesion of the upper labial mucosa which had the clinical appearance of a simple naevus.
  • Excision biopsy confirmed this to be a Spitz naevus.
  • This lesion shares histopathological similarities with malignant melanoma.
  • Spitz naevus is a benign lesion, but malignant transformation has been reported and close monitoring is recommended.
  • [MeSH-major] Lip Neoplasms / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Humans. Male. Melanoma / diagnosis. Mouth Mucosa / pathology

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  • (PMID = 17391924.001).
  • [ISSN] 0901-5027
  • [Journal-full-title] International journal of oral and maxillofacial surgery
  • [ISO-abbreviation] Int J Oral Maxillofac Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
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16. Da Forno PD, Fletcher A, Pringle JH, Saldanha GS: Understanding spitzoid tumours: new insights from molecular pathology. Br J Dermatol; 2008 Jan;158(1):4-14
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  • [Title] Understanding spitzoid tumours: new insights from molecular pathology.
  • Spitzoid tumours are a morphologically diverse group of lesions that share histological similarity to the Spitz naevus, a benign melanocytic skin tumour.
  • Distinguishing classic Spitz naevi from cutaneous malignant melanoma is usually achievable on standard histology sections, but occasionally equivocal lesions are encountered that show features intermediate between these two entities and consequently generate considerable clinical and histopathological concern.
  • The nomenclature and diagnostic criteria for spitzoid lesions are not standardized and this article begins by considering the adverse effect this has on our understanding of spitzoid tumour biology.
  • Investigations of some of the hallmark features of cancer and neoplasia in spitzoid tumours are described, and the contribution of these studies to our understanding of spitzoid tumour biology is considered, along with their potential diagnostic utility.
  • These studies compare spitzoid tumours with better-characterized melanocytic lesions, and from such comparisons assumptions concerning the biological nature of different spitzoid tumours can be made.
  • In contrast, investigations of the mitogen-activated protein kinase (MAPK) pathway and DNA gains and losses have suggested that Spitz naevi may be genetically distinct from other melanocytic tumours.
  • The studies that led to this conclusion are reviewed, as well as subsequent work examining whether the same applies to all spitzoid tumours.
  • Finally, potential pathways of tumour progression within spitzoid lesions are considered, with an emphasis placed upon insights gained from investigations of MAPK genes and DNA gains and losses.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / genetics. Skin Neoplasms / genetics
  • [MeSH-minor] Diagnosis, Differential. Disease Progression. Humans. MAP Kinase Signaling System / genetics. Melanoma / diagnosis. Melanoma / genetics


17. Thiagalingam S, Johnson MM, Colby KA, Zembowicz A: Juvenile conjunctival nevus: clinicopathologic analysis of 33 cases. Am J Surg Pathol; 2008 Mar;32(3):399-406
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  • [Title] Juvenile conjunctival nevus: clinicopathologic analysis of 33 cases.
  • Conjunctival nevi in children and adolescents often have histologic features that can be difficult to differentiate from malignancy.
  • We have identified a subset of childhood nevi displaying a confluent growth pattern and a lack of maturation that we have defined as juvenile conjunctival nevi (JCN), with the aim of further describing the clinicopathologic features of these lesions.
  • Lesions identified as conjunctival nevus in a tertiary referral hospital were reviewed and the subset of lesions identified as JCN were further evaluated.
  • Of the 40 conjunctival nevi identified, 33 fit the criteria for JCN.
  • Thirty-two lesions were of the compound type; one was a junctional nevus.
  • Maturation was absent in 21 of the compound nevi (66%, average age 10.3 y), and incomplete in the remaining 11 lesions (34%, average age 12.1 y).
  • The nuclei of the subepithelial nevus cells were larger than the epithelial nevus cells in 19 nevi (59%) and the same size in 13 (41%).
  • Recognition of JCN as a distinct morphologic variant of a conjunctival nevus with characteristic histologic features may help to distinguish this benign lesion from melanoma.
  • [MeSH-major] Conjunctival Neoplasms / pathology. Nevus / pathology

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  • (PMID = 18300811.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Stefanaki C, Stefanaki K, Antoniou C, Argyrakos T, Patereli A, Stratigos A, Katsambas A: Cell cycle and apoptosis regulators in Spitz nevi: comparison with melanomas and common nevi. J Am Acad Dermatol; 2007 May;56(5):815-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cell cycle and apoptosis regulators in Spitz nevi: comparison with melanomas and common nevi.
  • BACKGROUND: Deregulated cell cycle control is one of the hallmarks of tumor development.
  • The expression of different cell cycle regulators has been used in various neoplasms as an adjunct to diagnosis.
  • OBJECTIVE: We sough to determine the expression of cell cycle and apoptosis regulators in Spitz nevi and to appraise its value as a diagnostic adjunct in the differential diagnosis from melanomas and common nevi.
  • METHODS: Ki-67, p-27, p-16, p-53, p-21, Rb, cyclin D1, cyclin A, cyclin B1, bcl-2, and bax expression was assessed by immunohistochemistry in 10 Spitz nevi and was compared with 16 melanomas and 20 common nevi immunohistochemical expression.
  • RESULTS: P-27 (60% +/- 20.13), p-16 (62.00% +/- 10.85), and bcl-2 (46.00% +/- 42.47) were highly expressed in Spitz nevi, whereas Ki-67 (2.80% +/- 2.55), Rb (3.75% +/- 4.55), p-53 (2.30% +/- 0.10), cyclin A (0.70% +/- 1.56), B1 (0.20% +/- 0.34), and bax (2.65% +/- 6.37) demonstrated a limited expression.
  • The expression of bax (P = .001), Ki-67 (P < .0001), Rb (P < .0001), p-16 (P < .0001), cyclin A (P < .0001), and cyclin B1 (P < .0001) was significantly higher in melanomas in comparison with Spitz nevi, whereas p-27 expression was significantly higher in Spitz nevi (P < .0001).
  • A trend for significant difference in favor of melanomas was also observed for p-53 (P = .002).
  • Spitz nevi demonstrated a trend for a higher expression for p-21 (P = .008) and cyclin D1 (P = .006), whereas they exhibited lower p-16 (P = .004) in comparison with common nevi.
  • LIMITATIONS: The number of Spitz nevi was relatively small.
  • CONCLUSION: Spitz nevi differ from melanomas in their immunohistochemical pattern of expression of cell cycle and apoptosis regulators and more closely resemble common benign nevi.
  • [MeSH-major] Apoptosis / physiology. Cell Cycle Proteins / biosynthesis. Melanoma / physiopathology. Nevus, Epithelioid and Spindle Cell / physiopathology. Skin Neoplasms / physiopathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Male. Middle Aged. Nevus / diagnosis. Nevus / physiopathology


19. Cerroni L: A new perspective for spitz tumors? Am J Dermatopathol; 2005 Aug;27(4):366-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A new perspective for spitz tumors?
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • [CommentOn] Am J Dermatopathol. 2004 Feb;26(1):1-3 [14726816.001]
  • (PMID = 16121066.001).
  • [ISSN] 0193-1091
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Comment; Letter; Review
  • [Publication-country] United States
  • [Number-of-references] 2
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20. Glasgow MA, Lain EL, Kincannon JM: Agminated Spitz nevi: report of a child with a unique dermatomal distribution. Pediatr Dermatol; 2005 Nov-Dec;22(6):546-9
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  • [Title] Agminated Spitz nevi: report of a child with a unique dermatomal distribution.
  • Spitz nevi most commonly present as solitary lesions.
  • Multiple agminated Spitz nevi are a rare presentation, with 38 reported cases in the English language literature.
  • We report a 2-year-old girl who presented with multiple Spitz nevi in a unique, dermatome-like distribution and review the English-language literature on agminated Spitz nevi.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 16354259.001).
  • [ISSN] 0736-8046
  • [Journal-full-title] Pediatric dermatology
  • [ISO-abbreviation] Pediatr Dermatol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 40
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21. Troxel DB: Medicolegal aspects of error in pathology. Arch Pathol Lab Med; 2006 May;130(5):617-9
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  • RESULTS: Fifty-seven percent of malpractice claims involved just 5 categories of specimen type and/or diagnostic error, namely, breast specimens, melanoma, cervical Papanicolaou tests, gynecologic specimens, and system (operational) errors.
  • CONCLUSION: A false-negative diagnosis of melanoma was the single most common reason for filing a malpractice claim against a pathologist.
  • Nearly one third involved melanoma misdiagnosed as Spitz nevus, "dysplastic" nevus, spindle cell squamous carcinoma, atypical fibroxanthoma, and dermatofibroma.
  • While breast biopsy claims were a close second to melanoma, when combined with breast fine-needle aspiration and breast frozen section claims, breast specimens were the most common cause of pathology malpractice claims.
  • Cervical Papanicolaou test claims were third in frequency behind melanoma and breast; 98% involved false-negative Papanicolaou tests.
  • Forty-two percent of gynecologic surgical pathology claims involved misdiagnosed ovarian tumors, and 85% of these were false-negative diagnoses of malignancy.

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  • (PMID = 16683874.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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22. Nino M, Brunetti B, Delfino S, Brunetti B, Panariello L, Russo D: Spitz nevus: follow-up study of 8 cases of childhood starburst type and proposal for management. Dermatology; 2009;218(1):48-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spitz nevus: follow-up study of 8 cases of childhood starburst type and proposal for management.
  • Spitz nevus is an uncommon, benign melanocytic neoplasm that shares many clinical and histological features with melanoma.
  • We present our experience in the management of Spitz nevus by rigorous dermoscopic long-term follow-up of 8 Spitz nevi in patients younger than 12 years.
  • The aim of this paper is to better understand the long-term modifications of nevi with starburst pattern to avoid surgical excision of these lesions in the pediatric age group.
  • [MeSH-major] Dermoscopy. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology


23. Urso C: The atypical Spitz tumor of uncertain biologic potential: a series of 67 patients from a single institution. Cancer; 2010 Jan 1;116(1):258; author reply 258-9
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  • [Title] The atypical Spitz tumor of uncertain biologic potential: a series of 67 patients from a single institution.
  • [MeSH-major] Melanoma / pathology. Nevus / pathology. Sentinel Lymph Node Biopsy. Skin Neoplasms / pathology


24. Chao MM, Schwartz JL, Wechsler DS, Thornburg CD, Griffith KA, Williams JA: High-risk surgically resected pediatric melanoma and adjuvant interferon therapy. Pediatr Blood Cancer; 2005 May;44(5):441-8
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  • [Title] High-risk surgically resected pediatric melanoma and adjuvant interferon therapy.
  • BACKGROUND: Pediatric patients with high-risk surgically resected melanoma are at risk for relapse, yet little is known about these young patients and how they tolerate high-dose interferon therapy.
  • PROCEDURE: We reviewed medical records of patients (< or =18 years) with high-risk melanoma referred to the University of Michigan Pediatric Hematology-Oncology service between January 1989 and July 2003.
  • RESULTS: Fourteen patients were identified with high-risk resected melanoma.
  • Primary lesions were diagnosed as unequivocal melanoma, atypical epithelioid melanocytic proliferations, or atypical Spitz tumor with indeterminate malignant potential.
  • Twelve patients had a positive sentinel lymph node (SLN) biopsy or a palpable regional lymph node and underwent regional lymph node dissection (LND).
  • Two patients with unequivocal melanoma with Breslow depth >4 mm had negative SLN biopsies.
  • All patients are alive and free of disease at follow-up (median 24.5 months).
  • CONCLUSIONS: Invasive melanoma can occur in very young children.
  • Histologically, diagnosis may be difficult because of overlap with Spitz nevi.
  • [MeSH-major] Interferons / therapeutic use. Melanoma / drug therapy. Melanoma / pathology
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Male. Neoplasm Invasiveness. Neoplasm Metastasis. Retrospective Studies. Survival Rate

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  • [Copyright] 2004 Wiley-Liss, Inc.
  • [CommentIn] Pediatr Blood Cancer. 2005 May;44(5):431-2 [15514915.001]
  • (PMID = 15468307.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9008-11-1 / Interferons
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25. Murali R, Sharma RN, Thompson JF, Stretch JR, Lee CS, McCarthy SW, Scolyer RA: Sentinel lymph node biopsy in histologically ambiguous melanocytic tumors with spitzoid features (so-called atypical spitzoid tumors). Ann Surg Oncol; 2008 Jan;15(1):302-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sentinel lymph node biopsy in histologically ambiguous melanocytic tumors with spitzoid features (so-called atypical spitzoid tumors).
  • BACKGROUND: The distinction of Spitz nevi from melanomas with spitzoid morphology can be difficult.
  • The current study evaluated the role of sentinel lymph node (SLN) biopsy in patients with such atypical spitzoid tumors.
  • METHODS: The clinical and histopathologic features of 21 patients with atypical spitzoid tumors who underwent SLN biopsy were reviewed and correlated with the presence or absence of metastatic tumor in their corresponding SLNs.
  • There were histopathologic differences between tumors with positive SLN when compared with tumors with negative SLN: mean tumor thickness (3.38 mm vs. 2.04 mm), incomplete maturation (83% vs. 40%), median dermal mitotic rate (3.5/mm(2) vs. 2/mm(2)), deep dermal mitoses (83% vs. 47%), and expansile dermal nodules (50% vs. 13%).
  • However, of these, only the difference in mean tumor thickness reached statistical significance (P < .05).
  • CONCLUSIONS: SLN biopsy offers a means of assessing the metastatic potential of atypical spitzoid tumors and aids in the management of these patients by selecting patients who may benefit from a regional node field dissection and those in whom the use of adjuvant therapies could be considered.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Sentinel Lymph Node Biopsy. Skin Neoplasms / pathology

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  • (PMID = 18000712.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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26. Goh EH, Zarina AL, Thambidorai CR, Maizaton AA, Siti AM, Somasundram S: Amelanotic spitzoid melanoma in a prepubescent boy. Pediatr Surg Int; 2008 Apr;24(4):447-9
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  • [Title] Amelanotic spitzoid melanoma in a prepubescent boy.
  • The diagnosis of malignant melanoma (MM) in children is difficult due to its uncommon occurrence as well histological similarities to Spitz nevus.
  • A case of MM of the foot in an 11-year-old boy is reported illustrating the histological overlap between Spitz nevus and MM.
  • The literature on MM in children is limited and the documentation of such unusual cases is necessary to improve the knowledge on this disease.
  • [MeSH-major] Melanoma, Amelanotic / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • [Cites] Hum Pathol. 1998 Oct;29(10):1105-12 [9781649.001]
  • [Cites] Arch Dermatol. 2002 May;138(5):625-8 [12020223.001]
  • [Cites] Pathology. 2004 Oct;36(5):452-7 [15370115.001]
  • [Cites] Hum Pathol. 1999 May;30(5):513-20 [10333219.001]
  • [Cites] Pediatr Dermatol. 1997 Mar-Apr;14(2):87-92 [9144691.001]
  • (PMID = 17437116.001).
  • [ISSN] 0179-0358
  • [Journal-full-title] Pediatric surgery international
  • [ISO-abbreviation] Pediatr. Surg. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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27. Miettinen M, Fetsch JF: Reticulohistiocytoma (solitary epithelioid histiocytoma): a clinicopathologic and immunohistochemical study of 44 cases. Am J Surg Pathol; 2006 Apr;30(4):521-8
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  • [Title] Reticulohistiocytoma (solitary epithelioid histiocytoma): a clinicopathologic and immunohistochemical study of 44 cases.
  • In this study, we analyzed a uniform group of 44 lesions composed of epithelioid histiocytes, comprising a subset of lesions originally designated as reticulohistiocytoma, and propose designating them as "solitary epithelioid histiocytoma" (SEH), in line with the recently published classification proposal for histiocytic disorders.
  • They were composed of large epithelioid histiocytes with a varying number of lymphocytes and neutrophils.
  • Immunohistochemically, the epithelioid histiocytes were positive for CD163, CD68, lysozyme (variably), and vimentin.
  • The epithelioid histiocytes were consistently negative for CD3, CD20, CD30, HMB45, and keratins.
  • SEH is a benign, probably reactive, histiocytic proliferation of unknown etiology.
  • It needs to be distinguished from Rosai-Dorfman disease, juvenile xanthogranuloma, a variety of granulomatous conditions, and some malignant neoplasms, including histiocytic sarcoma, melanoma, and epithelioid sarcoma.
  • [MeSH-major] Epithelioid Cells / pathology. Histiocytoma, Benign Fibrous / pathology. Skin Neoplasms / pathology. Soft Tissue Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Biomarkers, Tumor / metabolism. Child. Child, Preschool. Diagnosis, Differential. Female. Histiocytoma, Malignant Fibrous / diagnosis. Histiocytosis, Sinus / diagnosis. Humans. Male. Middle Aged. Sarcoma / diagnosis. Sex Distribution. Xanthogranuloma, Juvenile / diagnosis

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  • (PMID = 16625100.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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28. Mooi WJ, Krausz T: Spitz nevus versus spitzoid melanoma: diagnostic difficulties, conceptual controversies. Adv Anat Pathol; 2006 Jul;13(4):147-56
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spitz nevus versus spitzoid melanoma: diagnostic difficulties, conceptual controversies.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology


29. Kapur P, Rakheja D, Roy LC, Hoang MP: Fatty acid synthase expression in cutaneous melanocytic neoplasms. Mod Pathol; 2005 Aug;18(8):1107-12
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  • Mammalian fatty acid synthase is a multifunctional enzyme complex involved in de novo synthesis of saturated fatty acids, and inhibitors of fatty acid synthase are being evaluated as potential therapeutic agents.
  • Increased fatty acid synthase expression has been demonstrated in subsets of malignancies, including colon, breast, endometrium, prostate and ovarian carcinomas, and recently malignant melanomas.
  • They included 30 congenital nevi, 19 compound nevi, 40 Spitz nevi, 48 primary melanomas, and 18 metastatic melanomas.
  • Fatty acid synthase expression was stronger in malignant melanomas in comparison to conventional nevi and Spitz nevi, and was the highest for metastatic melanoma.
  • Of the primary malignant melanomas, mean fatty acid synthase scores were significantly greater for Clark levels IV and V compared to Clark levels I and II (P<0.001).
  • In addition, melanomas with Breslow thickness 0.75-1.50 mm and >1.50 mm showed significantly higher mean fatty acid synthase scores compared with those with Breslow thickness <0.75 mm (P=0.013 and <0.001, respectively).
  • Of interest, congenital melanocytic nevi also showed strong fatty acid synthase expression, similar to that seen in metastatic melanoma.
  • [MeSH-major] Fatty Acid Synthases / biosynthesis. Melanoma / pathology. Nevus / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Child, Preschool. Female. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Metastasis. Nevus, Epithelioid and Spindle Cell / enzymology. Nevus, Epithelioid and Spindle Cell / pathology. Nevus, Pigmented / enzymology. Nevus, Pigmented / pathology

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  • (PMID = 15920554.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] EC 2.3.1.85 / Fatty Acid Synthases
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30. Urso C: A new perspective for spitz tumors? Am J Dermatopathol; 2005 Aug;27(4):364-6
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  • [Title] A new perspective for spitz tumors?
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Diagnosis, Differential. Humans. Melanoma / classification. Melanoma / pathology

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  • (PMID = 16121065.001).
  • [ISSN] 0193-1091
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Letter; Review
  • [Publication-country] United States
  • [Number-of-references] 47
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31. Nojavan H, Cribier B, Mehregan DR: [Desmoplastic Spitz nevus: a histopathological review and comparison with desmoplastic melanoma]. Ann Dermatol Venereol; 2009 Oct;136(10):689-95
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  • [Title] [Desmoplastic Spitz nevus: a histopathological review and comparison with desmoplastic melanoma].
  • [Transliterated title] Naevus de Spitz desmoplasique : analyse histopathologique et comparative avec le mélanome desmoplasique.
  • INTRODUCTION: Desmoplastic Spitz nevus is a rare variant of spitzoid tumours characterized by dermal proliferation of large epitheliod and/or fusiform melanocytes within a desmoplastic stroma, comprising thick, eosinophilic collagen bundles.
  • Histologically, this entity may be mistaken for cutaneous fibrous tumours or desmoplastic melanoma.
  • To establish useful histological criteria for differential diagnosis of desmoplastic Spitz nevus, we conducted a retrospective study comparing data concerning the clinical, demographic and histological characteristics of desmoplastic Spitz nevus and desmoplastic melanoma.
  • PATIENTS AND METHODS: We reviewed the slides for 28 cases of desmoplastic Spitz nevus and for 13 cases of desmoplastic melanoma obtained from the files of Pinkus Dermatopathology Laboratory (Monroe, MI, USA) during the period 1993-2005.
  • RESULTS: Desmoplastic Spitz nevus was more common in women (sex ratio M/F=0.4) and younger patients (mean age: 28.2 years) whereas the mean age of patients with desmoplastic melanoma was significantly higher (mean age: 75 years).
  • From a histopathological point of view, symmetry, circumscription, melanocytic maturation and involvement of adnexal structure were significantly more frequent in desmoplastic Spitz nevi.
  • The presence of melanocytic junctional nests associated with discohesive cells, variations in size and shape of the nests, lentiginous melanocytic proliferation, actinic elastosis, pagetoid spread, dermal mitosis, perineural involvement and brisk inflammatory infiltrate were significantly more frequent in desmoplastic melanoma.
  • CONCLUSION: The combination of architectural and cytological features was useful in differentiating desmoplastic Spitz nevus from desmoplastic melanoma.
  • A complete excision biopsy is mandatory in such tumors as the architectural criteria are necessary for a correct diagnosis.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 19801251.001).
  • [ISSN] 0151-9638
  • [Journal-full-title] Annales de dermatologie et de vénéréologie
  • [ISO-abbreviation] Ann Dermatol Venereol
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
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32. Cho SB, Kim HS, Jang H: A pedunculated hyalinizing Spitz nevus on the penile shaft. Int J Dermatol; 2009 Oct;48(10):1134-6
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  • [Title] A pedunculated hyalinizing Spitz nevus on the penile shaft.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Penile Neoplasms / pathology

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  • (PMID = 19775411.001).
  • [ISSN] 1365-4632
  • [Journal-full-title] International journal of dermatology
  • [ISO-abbreviation] Int. J. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] United States
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33. Helm TN, Helm KE: Classic and atypical Spitz nevi: review of the literature. Cutis; 2007 Sep;80(3):183; author reply 183
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  • [Title] Classic and atypical Spitz nevi: review of the literature.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / genetics. Nucleic Acid Hybridization. Skin Neoplasms / genetics
  • [MeSH-minor] Aneuploidy. Chromosomes, Human. Diagnosis, Differential. Humans. Melanoma / diagnosis. Melanoma / genetics

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  • [CommentOn] Cutis. 2007 Feb;79(2):141-6 [17388217.001]
  • (PMID = 17956003.001).
  • [ISSN] 0011-4162
  • [Journal-full-title] Cutis
  • [ISO-abbreviation] Cutis
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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34. Ferrara G, Zalaudek I, Argenziano G: Spitz nevus: an evolving clinicopathologic concept. Am J Dermatopathol; 2010 Jun;32(4):410-4
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  • [Title] Spitz nevus: an evolving clinicopathologic concept.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / classification. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / classification. Skin Neoplasms / pathology


35. Situm M, Bolanca Z, Buljan M, Tomas D, Ivancić M: Nevus Spitz--everlasting diagnostic difficulties--the review. Coll Antropol; 2008 Oct;32 Suppl 2:171-6
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  • [Title] Nevus Spitz--everlasting diagnostic difficulties--the review.
  • In 1910, Darier and Civatte described in details an unusual melanocytic tumor characterized by rapid growth on the nose of a young child.
  • They could not state whether the tumor was benign or malignant.
  • In 1947, Sophie Spitz described the same lesion as juvenile melanoma in which prognosis was frequently excellent.
  • Later, the study was revised and it was concluded that juvenile melanoma was a benign tumor and can affect adults.
  • Although, the prognosis was mostly excellent, Spitz reported in one of 13 cases fatal metastases from nevus Spitz.
  • In 1999, Barnhill et al described one fatal case of the patient for whom it was thought to have typical Spitz nevus.
  • Nowadays, there is still a lack of consensus about histopathology and also a terminology of the tumors that are neither typical nevus Spitz, neither malignant melanoma.
  • All histopathological, clinical and ancillary criteria must be weighed in the final interpretation of epitheloid/spindle cell lesion.
  • Barnhill recommends that all Spitz tumors are completely excised.
  • Atypical tumors should be excised with wider margins up to 1 cm.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology
  • [MeSH-minor] Diagnosis, Differential. Humans. Melanoma / pathology. Nevus / pathology. Skin Neoplasms / pathology

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  • (PMID = 19140279.001).
  • [ISSN] 0350-6134
  • [Journal-full-title] Collegium antropologicum
  • [ISO-abbreviation] Coll Antropol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Croatia
  • [Number-of-references] 28
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36. Wasco MJ, Pu RT, Yu L, Su L, Ma L: Expression of gamma-H2AX in melanocytic lesions. Hum Pathol; 2008 Nov;39(11):1614-20
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  • Previous studies have demonstrated the expression of gamma-H2AX in melanoma and dysplastic nevus, but its diagnostic and prognostic utility in a full range of melanocytic lesions has not been fully studied.
  • We found that gamma-H2AX was observed at higher levels (percentage and intensity of staining) in melanoma in situ (12/13), primary cutaneous melanoma (32/33; with the exception of desmoplastic melanoma), and metastatic melanoma (58/62), which was statistically different from that in benign nevus (7/9), dysplastic nevus (6/10), and Spitz nevus (5/9) considered together (P < .0001).
  • Of note, desmoplastic melanoma (20/26) demonstrated weak or negative gamma-H2AX staining.
  • The expression of gamma-H2AX did not show significant correlation with many melanoma prognostic factors, including Breslow depth, mitotic rate, and sentinel lymph node status.
  • Except for desmoplastic melanoma, no difference in gamma-H2AX levels was observed among various melanoma subtypes.
  • The overexpression of gamma-H2AX in melanoma as opposed to nevus indicates its possible role in melanomagenesis.
  • Based on the overlap in subsets of nevi and melanomas, the potential clinical utility of this antibody remains uncertain until further studies have been carried out in a larger cohort of melanocytic lesions, including borderline cases.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Histones / biosynthesis. Melanoma / metabolism. Nevus / metabolism
  • [MeSH-minor] Dysplastic Nevus Syndrome / metabolism. Female. Gene Expression. Humans. Male. Nevus, Epithelioid and Spindle Cell / metabolism. Skin Neoplasms / metabolism

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  • (PMID = 18656236.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / H2AFX protein, human; 0 / Histones
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37. Das S, Kirsch CF: Imaging of lumps and bumps in the nose: a review of sinonasal tumours. Cancer Imaging; 2005;5:167-77
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  • [Title] Imaging of lumps and bumps in the nose: a review of sinonasal tumours.
  • Sinonasal disease is one of the most common clinical head and neck pathologies.
  • The majority of sinonasal pathology is inflammatory with neoplasms comprising approximately 3% of all head and neck tumours.
  • Although sinus tumours are rare, they portend a poor prognosis, often due to advanced disease at diagnosis.
  • Like most neoplasms, early detection improves prognosis, therefore clinicians and radiologists should be aware of features separating tumours from inflammatory sinus disease.
  • This article reviews the anatomy, clinical features, imaging findings, treatment and histopathology of selected sinonasal tumours.
  • Benign neoplasms reviewed include osteoma, inverting papilloma, and juvenile nasal angiofibroma.
  • Malignant neoplasms reviewed include squamous cell carcinoma, the minor salivary gland tumour, adenoid cystic carcinoma, adenocarcinoma, melanoma, lymphoma, and olfactory neuroblastoma (esthesioneuroblastoma).

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  • [Copyright] International Cancer Imaging Society.
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  • (PMID = 16361146.001).
  • [ISSN] 1470-7330
  • [Journal-full-title] Cancer imaging : the official publication of the International Cancer Imaging Society
  • [ISO-abbreviation] Cancer Imaging
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 73
  • [Other-IDs] NLM/ PMC1665243
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38. Takata M, Suzuki T, Ansai S, Kimura T, Shirasaki F, Hatta N, Saida T: Genome profiling of melanocytic tumors using multiplex ligation-dependent probe amplification (MLPA): Its usefulness as an adjunctive diagnostic tool for melanocytic tumors. J Dermatol Sci; 2005 Oct;40(1):51-7
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  • [Title] Genome profiling of melanocytic tumors using multiplex ligation-dependent probe amplification (MLPA): Its usefulness as an adjunctive diagnostic tool for melanocytic tumors.
  • BACKGROUND: The histopathology of melanocytic tumors sometimes presents diagnostic problems.
  • OBJECTIVE: We assessed the feasibility of multiplex ligation-dependent probe amplification (MLPA), a novel PCR-based genome profiling method, in the classification of melanocytic tumors.
  • METHOD: We extracted DNA from paraffin-embedded tissue sections of 24 primary melanomas, 14 Spitz nevi and 17 common melanocytic nevi.
  • We analyzed the copy number gains or losses of a total of 76 genes spanning almost all chromosome arms using commercially available MLPA kits.
  • RESULTS: Although four melanocytic nevi and three Spitz nevi did not yield sufficient DNA for reliable analysis due to small tumor size, the MLPA analysis was feasible and applicable to the remaining 88% of samples.
  • We found multiple genetic aberrations in primary melanomas.
  • The total number of aberrations in each tumor ranged from 1 to 32 (average, 12.04).
  • All but two melanomas showed aberrations at more than three genetic loci.
  • Seventeen (70.8%) of the 24 melanomas showed a copy number loss of either the CDKN2A or CDKN2B gene on chromosome 9p21.
  • All the Spitz nevi and 7 (50%) of 14 common melanocytic nevi had copy number changes at one or two gene loci (average, 1.04).
  • The receiver operator characteristic curve analysis showed that the threshold value of copy number aberrations corresponding to 98% specificity for melanoma was 2.42 and the sensitivity using this threshold value was 92.5%.
  • CONCLUSIONS: MLPA could be used as an adjunctive diagnostic tool for melanocytic tumors.
  • [MeSH-major] Melanoma / diagnosis. Molecular Probe Techniques. Nucleic Acid Amplification Techniques / methods. Skin Neoplasms / diagnosis
  • [MeSH-minor] Cell Cycle Proteins / genetics. Cyclin-Dependent Kinase Inhibitor p15. Female. Gene Dosage. Gene Expression Profiling. Genes, p16. Humans. Loss of Heterozygosity. Tumor Suppressor Proteins / genetics

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  • (PMID = 16054806.001).
  • [ISSN] 0923-1811
  • [Journal-full-title] Journal of dermatological science
  • [ISO-abbreviation] J. Dermatol. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / CDKN2B protein, human; 0 / Cell Cycle Proteins; 0 / Cyclin-Dependent Kinase Inhibitor p15; 0 / Tumor Suppressor Proteins
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39. Winfield HL, Kirkland F, Ramos-Ceballos FI, Horn TD: Osteopontin expression in Spitz nevi. Arch Dermatol; 2007 Aug;143(8):1076-7
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  • [Title] Osteopontin expression in Spitz nevi.
  • [MeSH-major] Melanoma / metabolism. Nevus, Epithelioid and Spindle Cell / metabolism. Osteopontin / metabolism. Skin Neoplasms / metabolism

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  • (PMID = 17709675.001).
  • [ISSN] 0003-987X
  • [Journal-full-title] Archives of dermatology
  • [ISO-abbreviation] Arch Dermatol
  • [Language] eng
  • [Publication-type] Comparative Study; Letter
  • [Publication-country] United States
  • [Chemical-registry-number] 106441-73-0 / Osteopontin
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40. Kwon OE, Ku BS, Lee YK, Kim YH, Kim KH: Angiomatoid Spitz Nevus. Ann Dermatol; 2008 Mar;20(1):14-7
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  • [Title] Angiomatoid Spitz Nevus.
  • Spitz nevus is a variant of melanocytic nevus which is histopathologically defined as large spindle and/or epithelioid cells.
  • Angiomatoid Spitz nevus is a rare histologic variant of desmoplastic Spitz nevus characterized by prominent vasculature.
  • We present a case of angiomatoid Spitz nevus, celluar type, that has not been reported before.
  • We provide another example to show the remarkable diversity of Spitz nevus.

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  • (PMID = 27303151.001).
  • [ISSN] 1013-9087
  • [Journal-full-title] Annals of dermatology
  • [ISO-abbreviation] Ann Dermatol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC4904041
  • [Keywords] NOTNLM ; Angiomatoid spitz nevus / Desmoplastic spitz nevus / Spindle and/or epithelioid cells
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41. Vervaet N, Van Ginderdeuren R, Van Den Oord JJ, Foets B: A rare conjunctival Spitz nevus: a case report and literature review. Bull Soc Belge Ophtalmol; 2007;(303):63-7
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  • [Title] A rare conjunctival Spitz nevus: a case report and literature review.
  • A conjunctival Spitz nevus is a very rare, benign melanocytic lesion, which can be mistaken for a malignant melanoma.
  • We present a case of a 28-year old man, who suffered from a rapidly growing, non-pigmented mass in the left caruncular area, extending to the nasal conjunctiva.
  • The lesion was excised and pathologic examination showed nests of large, polygonal, non-pigmented epithelioid cells, located in the stroma.
  • Immunohistochemical techniques, with stainings for S-100 protein, HMB-45 and MIB-1, were used for further investigation and showed the melanocytic origin of the lesion (S-100 staining) as well as many cells in cell cycle (MIB-1 staining).
  • The clinical image, combined with pathologic and immunohistochemical findings, provided the diagnosis of a Spitz nevus localised in the conjunctiva.
  • Although the cutaneous location of Spitz nevi is well known, conjunctival Spitz nevi are very rare and because of their mucosal origin, some of the histological features are different.
  • [MeSH-major] Conjunctival Neoplasms / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis

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  • (PMID = 17894290.001).
  • [ISSN] 0081-0746
  • [Journal-full-title] Bulletin de la Société belge d'ophtalmologie
  • [ISO-abbreviation] Bull Soc Belge Ophtalmol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Belgium
  • [Number-of-references] 10
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42. Berk DR, LaBuz E, Dadras SS, Johnson DL, Swetter SM: Melanoma and melanocytic tumors of uncertain malignant potential in children, adolescents and young adults--the Stanford experience 1995-2008. Pediatr Dermatol; 2010 May-Jun;27(3):244-54
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  • [Title] Melanoma and melanocytic tumors of uncertain malignant potential in children, adolescents and young adults--the Stanford experience 1995-2008.
  • Pediatric melanoma is difficult to study because of its rarity, possible biological differences in preadolescents compared with adolescents, and challenges of differentiating true melanoma from atypical spitzoid neoplasms.
  • Indeterminant lesions are sometimes designated as melanocytic tumors of uncertain malignant potential (MelTUMPs).
  • We performed a retrospective, single-institution review of melanomas, MelTUMPs and Spitz nevi with atypical features (SNAFs) in patients at 21 years of age and younger from 1995 to 2008.
  • We identified 13 patients with melanoma, seven with MelTUMPs, and five with SNAFs.
  • The median age for melanoma patients was 17 years, 10 for MelTUMPs, and six for SNAFs.
  • Of the 13 melanoma patients, only four were younger than 15 years, while six were adolescents, and three were young adults.
  • Nine melanoma patients (69%) were female.
  • The median depth for melanomas was 1.2 mm, and 3.4 mm for MelTUMPs.
  • Microscopic regional nodal involvement detected on elective or sentinel lymph node (SLN) dissection was present in 2/10 (20%) of primary melanomas and 2/6 (33%) of Mel-TUMPs.
  • Complete lymphadenectomy was performed on four melanoma patients, with three positive cases.
  • One SLN-positive patient (8%) with melanoma developed recurrent lymph node and liver metastasis and died 15 months after primary diagnosis.
  • Our data highlight the rarity, female predominance, and significant rate of SLN positivity of pediatric melanoma.
  • The high rate of MelTUMPs with regional nodal disease reinforces the need for close follow-up.
  • [MeSH-major] Melanoma / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 20403119.001).
  • [ISSN] 1525-1470
  • [Journal-full-title] Pediatric dermatology
  • [ISO-abbreviation] Pediatr Dermatol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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43. Kashani-Sabet M, Rangel J, Torabian S, Nosrati M, Simko J, Jablons DM, Moore DH, Haqq C, Miller JR 3rd, Sagebiel RW: A multi-marker assay to distinguish malignant melanomas from benign nevi. Proc Natl Acad Sci U S A; 2009 Apr 14;106(15):6268-72
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  • [Title] A multi-marker assay to distinguish malignant melanomas from benign nevi.
  • The histopathological diagnosis of melanoma can be challenging.
  • No currently used molecular markers accurately distinguish between nevus and melanoma.
  • Recent transcriptome analyses have shown the differential expression of several genes in melanoma progression.
  • Here, we describe a multi-marker diagnostic assay using 5 markers (ARPC2, FN1, RGS1, SPP1, and WNT2) overexpressed in melanomas.
  • Immunohistochemical marker expression was analyzed in 693 melanocytic neoplasms comprising a training set (tissue microarray of 534 melanomas and nevi), and 4 independent validation sets: tissue sections of melanoma arising in a nevus; dysplastic nevi; Spitz nevi; and misdiagnosed melanocytic neoplasms.
  • Based on the differential expression of these 5 markers between nevi and melanomas in the training set, a diagnostic algorithm was obtained.
  • Using this algorithm, the lesions in the validation sets were diagnosed as nevus or melanoma, and the results were compared with the known histological diagnoses.
  • Both the intensity and pattern of expression of each marker were significantly different in melanomas compared to nevi.
  • The diagnostic algorithm exploiting these differences achieved a specificity of 95% and a sensitivity of 91% in the training set.
  • In the validation sets, the multi-marker assay correctly diagnosed a high percentage of melanomas arising in a nevus, Spitz nevi, dysplastic nevi, and misdiagnosed lesions.
  • The multi-marker assay described here can aid in the diagnosis of melanoma.

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  • (PMID = 19332774.001).
  • [ISSN] 1091-6490
  • [Journal-full-title] Proceedings of the National Academy of Sciences of the United States of America
  • [ISO-abbreviation] Proc. Natl. Acad. Sci. U.S.A.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA114337-04; United States / NCI NIH HHS / CA / R01 CA114337-02S1; United States / NCI NIH HHS / CA / CA122947-01A1; United States / NCI NIH HHS / CA / R01 CA114337; United States / NCI NIH HHS / CA / R01 CA114337-03; United States / NCI NIH HHS / CA / CA122947; United States / NCI NIH HHS / CA / CA122947-02; United States / NCI NIH HHS / CA / R01 CA122947-03; United States / NCI NIH HHS / CA / R01 CA114337-04; United States / NCI NIH HHS / CA / R01 CA122947-01A1; United States / NCI NIH HHS / CA / R01 CA122947; United States / NCI NIH HHS / CA / CA114337-03; United States / NCI NIH HHS / CA / CA122947-03; United States / NCI NIH HHS / CA / CA114337-02S1; United States / NCI NIH HHS / CA / R01 CA122947-02; United States / NCI NIH HHS / CA / CA114337
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Other-IDs] NLM/ PMC2662963
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44. Takata M, Lin J, Takayanagi S, Suzuki T, Ansai S, Kimura T, Cerroni L, Saida T: Genetic and epigenetic alterations in the differential diagnosis of malignant melanoma and spitzoid lesion. Br J Dermatol; 2007 Jun;156(6):1287-94
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  • [Title] Genetic and epigenetic alterations in the differential diagnosis of malignant melanoma and spitzoid lesion.
  • BACKGROUND: The histopathological differentiation of malignant melanoma and Spitz naevus often presents diagnostic problems.
  • METHODS: The cases included conventional melanomas and Spitz naevi as well as atypical spitzoid lesions that had posed diagnostic difficulties.
  • RESULTS: Twenty three of 24 conventional melanomas showed at least one of the genetic and epigenetic alterations examined, although one acral melanoma did not show any alteration.
  • By sharp contrast, 12 Spitz naevi with an unambiguous histopathology showed no or few chromosomal aberrations, no oncogene mutations and no methylation of CpG sequences.
  • Of the 16 ambiguous spitzoid lesions, most of which were designated atypical Spitz tumour by one of the authors, all but one showed no mutations, no methylations and few copy number aberrations.
  • However, three tumours showed copy number loss of the cyclin-dependent kinase inhibitor 2A gene (CDKN2A), an alteration observed frequently in melanomas but not found in conventional Spitz naevi.
  • These results show that, although most atypical Spitz tumours do not differ from conventional Spitz naevi showing virtually no genetic and epigenetic aberrations, some cases may have chromosomal aberrations that include copy number loss of the CDKN2A gene.
  • CONCLUSIONS: Genetic and epigenetic analyses may be useful as an additional diagnostic tool to distinguish between melanoma and Spitz naevus, and may help to define subgroups in atypical Spitz tumours.
  • [MeSH-major] Melanoma / diagnosis. Mutation / genetics. Nevus, Epithelioid and Spindle Cell / diagnosis. Skin Neoplasms / diagnosis


45. Eroğlou A, Uğurluoğlu C: Spitz nevus of the tongue with pseudoepitheliomatous hyperplasia: a case report. J BUON; 2005 Oct-Dec;10(4):555-7
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  • [Title] Spitz nevus of the tongue with pseudoepitheliomatous hyperplasia: a case report.
  • Spitz nevus is a rare tumor, most commonly arising from the skin.
  • We report on a case of Spitz nevus of the tongue in a 14-year-old girl.
  • She underwent local excision and the histopathological and immunohistochemical (IHC) studies by using AEC chromogen peroxidase conjugate indicated Spitz with pseudoepitheliomatous hyperplasia.

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  • (PMID = 17357216.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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46. Isabel Zhu Y, Fitzpatrick JE: Expression of c-kit (CD117) in Spitz nevus and malignant melanoma. J Cutan Pathol; 2006 Jan;33(1):33-7
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  • [Title] Expression of c-kit (CD117) in Spitz nevus and malignant melanoma.
  • BACKGROUND: CD117, the receptor for kit-ligand, which is a growth factor for melanocyte migration and proliferation, has shown differential staining in various benign and malignant melanocytic lesions.
  • The purpose of this study is to compare CD117 immunohistological staining in Spitz nevus versus malignant melanoma, to determine whether CD117 can aid in the diagnosis of these two lesions.
  • METHODS: CD-117 immunohistological staining was performed in 22 clinically and pathologically diagnosed pigmented lesions including 9 cases of Spitz nevus, 10 cases of primary MM and 3 cases of metastatic melanoma.
  • RESULTS: There was no significant difference in CD117 staining in either epidermis or dermis between Spitz nevi and primary melanomas.
  • However staining of metastatic melanomas is less than dermal staining of primary MM and Spitz nevus.
  • CONCLUSIONS: CD117 is unlikely a useful diagnostic tool in differentiating Spitz nevus from primary MM.
  • On the other hand, CD 117 may be useful in differentiating metastatic melanoma from primary melanoma in patients who had a history of melanoma and who present with new dermal lesions.
  • [MeSH-major] Melanoma / metabolism. Nevus, Epithelioid and Spindle Cell / metabolism. Proto-Oncogene Proteins c-kit / metabolism. Skin Neoplasms / metabolism
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Diagnosis, Differential. Humans. Immunohistochemistry. Melanocytes / metabolism. Melanocytes / pathology. Retrospective Studies

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  • (PMID = 16441409.001).
  • [ISSN] 0303-6987
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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47. Diwan AH, Dang SM, Prieto VG, Ellerhorst JA: Lack of maturation with anti-leptin receptor antibody in melanoma but not in nevi. Mod Pathol; 2009 Jan;22(1):103-6
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  • [Title] Lack of maturation with anti-leptin receptor antibody in melanoma but not in nevi.
  • We have previously shown thryotropin-releasing hormone expression in nevi and melanoma.
  • The present study was therefore undertaken to evaluate leptin and leptin receptor in nevi and melanoma.
  • Leptin receptor expression as assessed using an anti-leptin receptor antibody showed uniform expression throughout the lesion in 14 of 17 melanomas; 3 melanomas lacked leptin receptor immunoreactivity.
  • In contrast, out of 15 nevi, 10 showed weak to moderate leptin receptor immunoreactivity, with positivity present only in the superficial dermal component.
  • Thus, maturation was present in nevi but not in melanoma with the anti-leptin receptor antibody (P<0.0001).
  • Anti-leptin antibody, in contrast, did not show a significant difference in maturation between nevi and melanoma.
  • We also compared leptin receptor in Spitz nevi and melanoma, as the two can sometimes be difficult to distinguish.
  • Spitz nevi showed moderate to strong immunopositivity.
  • Of 19 Spitz nevi, 7 showed lack of maturation, a finding statistically significant from both melanoma and nevi.
  • Our results suggest a role for leptin receptor in melanoma, and we show for the first time that melanomas show more intense immunoreactivity as compared to nevi (but not Spitz nevi) and that maturation with anti-leptin receptor antibody may be a diagnostically useful tool in distinguishing melanomas, especially nevoid ones, from nevi in difficult cases.
  • [MeSH-major] Biomarkers, Tumor / analysis. Melanoma / pathology. Nevus / pathology. Receptors, Leptin / biosynthesis. Skin Neoplasms / pathology

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  • (PMID = 18836419.001).
  • [ISSN] 1530-0285
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies; 0 / Biomarkers, Tumor; 0 / Leptin; 0 / Receptors, Leptin
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48. Glatz K, Hartmann C, Antic M, Kutzner H: Frequent mitotic activity in banal melanocytic nevi uncovered by immunohistochemical analysis. Am J Dermatopathol; 2010 Oct;32(7):643-9
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  • [Title] Frequent mitotic activity in banal melanocytic nevi uncovered by immunohistochemical analysis.
  • We evaluated the number and distribution of mitotic figures in 353 randomly collected melanocytic nevi of various subtypes by hematoxylin and eosin (H&E) staining and immunohistochemically with the 2 mitotic markers Phospho-Histone H3 Ser28 (PHH3) and MPM2.
  • In common compound nevi, the mean number of dermal mitoses amounted to 0.024/mm dermal surface area in the H&E staining (PHH3: 0.061; MPM2: 0.087) and to 0.175/mm in Spitz nevi (PHH3: 0.325; MPM2: 0.45).
  • Nevi exhibiting mitotic figures were significantly more frequent in the youngest age group (0-20 years) than in patients older than 50 years (P < 0.0001).
  • Mitotic activity in obviously benign melanocytic nevi is not rare even in the deep dermal part.
  • More than 2 mitotic figures per lesion can usually be explained either by the nevus subtype, young patient age, traumatization, or inflammation.
  • PHH3 and MPM2 are a valuable diagnostic adjunct in the evaluation of melanocytic tumors allowing more sensitive and faster recognition of mitotic figures and their distribution.
  • [MeSH-major] Melanoma / pathology. Mitosis. Nevus, Pigmented / pathology. Skin Neoplasms / pathology


49. Gerami P, Barnhill RL, Beilfuss BA, LeBoit P, Schneider P, Guitart J: Superficial melanocytic neoplasms with pagetoid melanocytosis: a study of interobserver concordance and correlation with FISH. Am J Surg Pathol; 2010 Jun;34(6):816-21
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  • Pagetoid proliferation of single melanocytic cells or small nests of melanocytes may be seen in a variety of melanocytic neoplasms including pagetoid spitz nevi, de novo epithelioid melanocytic dysplasia, and melanoma.
  • We allowed 3 experienced consultant dermatopathologists to independently evaluate these entities and score them from 1 to 4, with 1 being totally benign and 4 being melanoma.
  • In addition, we performed fluorescence in-situ hybridization (FISH) using a new melanoma FISH assay targeting 6p25, 6q23, Cep6, and 11q13.
  • We found that FISH accurately identified as malignant 5 of 7 cases which had a consensus diagnosis of melanoma.
  • None of the cases with a consensus diagnosis of benign were FISH positive.
  • One of these 2 cases showed definitive histologic changes of melanoma on later complete re-excision.
  • [MeSH-major] Melanoma / diagnosis. Melanoma / genetics. Precancerous Conditions / diagnosis. Skin Neoplasms / diagnosis. Skin Neoplasms / genetics
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Humans. In Situ Hybridization, Fluorescence. Male. Middle Aged. Nevus, Epithelioid and Spindle Cell / diagnosis. Nevus, Epithelioid and Spindle Cell / epidemiology. Nevus, Epithelioid and Spindle Cell / genetics. Observer Variation. Young Adult


50. Pryor JG, Bourne PA, Yang Q, Spaulding BO, Scott GA, Xu H: IMP-3 is a novel progression marker in malignant melanoma. Mod Pathol; 2008 Apr;21(4):431-7
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  • [Title] IMP-3 is a novel progression marker in malignant melanoma.
  • IMP-3 expression in melanoma was significantly higher than in Spitz nevi (P<0.05), and the staining intensity in the Spitz nevi was weak.
  • IMP-3 expression in metastatic melanoma was significantly higher than in primary cutaneous melanoma with a Breslow depth </=1 mm (P<0.01).
  • None of the benign nevi and dysplastic nevi expressed IMP-3.
  • Our study demonstrates that IMP-3 is expressed in malignant melanoma but not in benign nevi, even when dysplastic features are present; IMP-3 is expressed in a significantly higher proportion of melanomas than Spitz nevi; and IMP-3 is expressed in metastatic melanomas significantly more than in thin melanomas.
  • In conclusion, IMP-3 appears to be involved in the progression of malignant melanoma and may play an important role in the regulation of the biologic behavior of this tumor.
  • Additionally, IMP-3 may have diagnostic utility in distinguishing melanoma from benign nevic cells, dysplastic nevi, and Spitz nevi.
  • [MeSH-major] Biomarkers, Tumor / analysis. Melanoma / metabolism. Melanoma / pathology. Neoplasm Proteins / metabolism. RNA-Binding Proteins / metabolism. Skin Neoplasms / metabolism. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Diagnosis, Differential. Disease Progression. Female. Humans. Immunohistochemistry. Male. Middle Aged. Nevus / metabolism. Nevus / pathology. Precancerous Conditions / metabolism. Precancerous Conditions / pathology

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  • (PMID = 18204432.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / IMP3 protein, human; 0 / Neoplasm Proteins; 0 / RNA-Binding Proteins
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51. Kantrow SM, Boyd AS, Ellis DL, Nanney LB, Richmond A, Shyr Y, Robbins JB: Expression of activated Akt in benign nevi, Spitz nevi and melanomas. J Cutan Pathol; 2007 Aug;34(8):593-6
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  • [Title] Expression of activated Akt in benign nevi, Spitz nevi and melanomas.
  • BACKGROUND: Activated Akt expression (p-Akt) is reportedly increased in many melanomas as compared with benign nevi.
  • The purpose of this study was to evaluate and compare p-Akt immunohistological staining in benign nevi, Spitz nevi and primary melanomas.
  • METHODS: Immunostaining for phosphorylated Akt was performed in 41 melanocytic lesions previously classified as benign intradermal nevus (14 lesions), Spitz nevus (9 lesions) or melanoma (18 lesions).
  • RESULTS: Benign nevi showed less staining (mean score 1.18) compared with Spitz nevi (mean score 2.11) and melanomas (mean score 2.19).
  • This difference was statistically significant between benign nevi and melanomas (p = 0.0047) and benign nevi and Spitz nevi (p = 0.0271).
  • No statistical difference was detected in staining between Spitz nevi and melanomas (p = 0.8309).
  • CONCLUSIONS: Activated Akt expression is increased in Spitz nevi and melanomas as compared with benign intradermal nevi, but is unlikely to prove useful in differentiating between the former.

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  • (PMID = 17640227.001).
  • [ISSN] 0303-6987
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA098807; United States / NCI NIH HHS / CA / R01 CA098807-04; United States / NCI NIH HHS / CA / CA116021-03; United States / NCI NIH HHS / CA / R01 CA116021; United States / NCI NIH HHS / CA / R01 CA116021-03
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; EC 2.7.11.1 / Proto-Oncogene Proteins c-akt
  • [Other-IDs] NLM/ NIHMS49408; NLM/ PMC2665272
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52. Scope A, Benvenuto-Andrade C, Agero AL, Halpern AC, Gonzalez S, Marghoob AA: Correlation of dermoscopic structures of melanocytic lesions to reflectance confocal microscopy. Arch Dermatol; 2007 Feb;143(2):176-85
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  • SETTING: Dermatology clinic specializing in pigmented lesions.
  • Patients Eleven patients with melanocytic lesions, including 2 melanomas, 1 Spitz nevus, 7 dysplastic nevi, and 1 compound nevus.
  • CONCLUSION: Correlating dermoscopic structures to RCM features is possible and a necessary step toward understanding the potential benefits of RCM in the clinical setting.
  • [MeSH-major] Dermoscopy. Melanoma / pathology. Microscopy, Confocal. Nevus, Epithelioid and Spindle Cell / pathology. Nevus, Pigmented / pathology. Skin Neoplasms / pathology

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  • (PMID = 17309998.001).
  • [ISSN] 0003-987X
  • [Journal-full-title] Archives of dermatology
  • [ISO-abbreviation] Arch Dermatol
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] United States
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53. Fullen DR, Poynter JN, Lowe L, Su LD, Elder JT, Nair RP, Johnson TM, Gruber SB: BRAF and NRAS mutations in spitzoid melanocytic lesions. Mod Pathol; 2006 Oct;19(10):1324-32
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  • BRAF mutations are common events in a variety of melanocytic nevi and primary cutaneous melanomas.
  • We have previously found BRAF mutations in 82% of nevi, consisting of congenital, common acquired and dysplastic types, and 33% of primary cutaneous melanomas other than the spitzoid type, similar to other published reports.
  • A small number of studies have evaluated Spitz nevi and have failed to detect any lesions possessing a BRAF mutation.
  • Only one study included categories of atypical Spitz nevus and borderline lesions suspected to be spitzoid melanomas, along with classic Spitz nevi and spitzoid melanomas.
  • We examined a spectrum of spitzoid lesions that included 48 Spitz nevi, some with atypical features, seven atypical (borderline) Spitz tumors, and 13 spitzoid melanomas.
  • BRAF mutations were detected in 12 of 68 spitzoid lesions, of which two were spitzoid melanomas and 10 were Spitz nevi.
  • Five of the 10 Spitz nevi with BRAF mutations were altered by more than usual cytologic atypia and/or architectural atypia overlapping with dysplastic nevi, or irritation/inflammation; one desmoplastic Spitz nevus had a BRAF mutation.
  • These results indicate that a small subset of Spitz nevi, some with atypical histologic features, possess BRAF mutations.
  • Therefore, the BRAF mutational status does not separate all Spitz nevi from spitzoid melanomas and non-Spitz types of melanocytic proliferations, contrary to previous reports.
  • [MeSH-major] Melanoma / genetics. Mutation. Nevus, Epithelioid and Spindle Cell / genetics. Proto-Oncogene Proteins B-raf / genetics. Proto-Oncogene Proteins p21(ras) / genetics. Skin Neoplasms / genetics

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  • (PMID = 16799476.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Grant] United States / NHGRI NIH HHS / HG / T32 HG00040; United States / NCI NIH HHS / CA / U01 CA83180
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] EC 2.7.11.1 / BRAF protein, human; EC 2.7.11.1 / Proto-Oncogene Proteins B-raf; EC 3.6.5.2 / Proto-Oncogene Proteins p21(ras)
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54. Al Dhaybi R, Sartelet H, Powell J, Kokta V: Expression of CD133+ cancer stem cells in childhood malignant melanoma and its correlation with metastasis. Mod Pathol; 2010 Mar;23(3):376-80
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  • [Title] Expression of CD133+ cancer stem cells in childhood malignant melanoma and its correlation with metastasis.
  • Cancer stem cells expressing CD133 exist in a wide array of tumors and their identification in malignant melanoma may help refine classification, diagnosis and treatment.
  • To study the correlation between CD133 expression in childhood melanoma and lymph node and/or visceral metastasis, we evaluated 12 cases of malignant melanoma and 12 control cases of Spitz nevus occurring in children.
  • Three melanoma patients had lymph node metastasis and only one had multivisceral metastases; CD133 was positive only in these four patients.
  • The Ki-67 index was lower in the CD133(+) cells in comparison with the CD133(-) melanoma cells in three cases.
  • We found no positivity for CD133 in all the Spitz nevi.
  • CD133(+) cancer stem cell expression in childhood malignant melanoma might correlate with lymph node and/or visceral metastasis and may have a low proliferative Ki-67 index that might explain their chemoresistance.
  • [MeSH-major] Antigens, CD / metabolism. Glycoproteins / metabolism. Melanoma / secondary. Neoplastic Stem Cells / metabolism. Peptides / metabolism. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Biomarkers, Tumor / metabolism. Child. Child, Preschool. Female. Humans. Ki-67 Antigen / metabolism. Lymph Nodes / pathology. Lymphatic Metastasis. Male. Neoplasm Metastasis. Neoplasm Staging. Nevus, Epithelioid and Spindle Cell / metabolism. Survival Rate


55. Wang L, Wang G, Fan P, Gao T: Linear arrangement of hypopigmented Spitz nevi on the ear after trauma. J Dermatol; 2010 Apr;37(4):346-9
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  • [Title] Linear arrangement of hypopigmented Spitz nevi on the ear after trauma.
  • Histopathological examination of two separate lesions showed proliferation of epithelioid cells in the dermis and some of them formed nests.
  • No melanin was found in the epithelioid cells, and immunohistochemistry staining with S100, HMB45 and Melan-A were positive in the neoplasm cells.
  • According to the clinical and histopathological characteristics, it was diagnosed as hypopigmented Spitz nevi with linear arrangement after trauma.
  • [MeSH-major] Ear / injuries. Hypopigmentation / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Cell Proliferation. Child. Humans. Immunohistochemistry. Male

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  • (PMID = 20507404.001).
  • [ISSN] 1346-8138
  • [Journal-full-title] The Journal of dermatology
  • [ISO-abbreviation] J. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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56. Rütten A: [Spitz nevus vs 'spitzoid' malignant melanoma. A diagnostic dilemma?]. Pathologe; 2007 Nov;28(6):422-9
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  • [Title] [Spitz nevus vs 'spitzoid' malignant melanoma. A diagnostic dilemma?].
  • [Transliterated title] Nävus Spitz vs. "spitzoides" malignes Melanom. Ein diagnostisches Dilemma?
  • Data from the literature and histopathological findings in six personal cases are used to illustrate criteria that can be applied in differential diagnosis between a Spitz nevus and a spitzoid variant of malignant melanoma.
  • The diagnostic term 'atypical Spitz tumor' is explained; it is used to describe a morphological "grey zone" in which it is not possible to differentiate with adequate certainty between a Spitz nevus and a spitzoid malignant melanoma.
  • [MeSH-major] Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Nevus, Pigmented / pathology. Skin Neoplasms / pathology

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  • (PMID = 17846775.001).
  • [ISSN] 0172-8113
  • [Journal-full-title] Der Pathologe
  • [ISO-abbreviation] Pathologe
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
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57. Requena C, Requena L, Kutzner H, Sánchez Yus E: Spitz nevus: a clinicopathological study of 349 cases. Am J Dermatopathol; 2009 Apr;31(2):107-16
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  • [Title] Spitz nevus: a clinicopathological study of 349 cases.
  • Spitz nevus is an infrequent, usually acquired melanocytic nevus composed of epithelioid and/or spindle melanocytes that can occasionally be confused with melanoma.
  • Currently, there are no immunohistochemical markers or molecular biology techniques that can be used to make an entirely safe diagnosis of Spitz nevus or melanoma in problematic cases.
  • A retrospective study has been carried out that included all the cases diagnosed as Spitz nevus from our files.
  • Three hundred forty-nine cases of unequivocal Spitz nevi were included, and their clinical and histopathological parameters were reviewed.
  • Spitz nevus was most commonly located on the lower extremities, followed by the trunk in both children and adults.
  • The constitution by epithelioid and/or spindled cells was the only histopathological finding present in 100% of cases.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin / pathology. Skin Neoplasms / pathology


58. Massi G: Melanocytic nevi simulant of melanoma with medicolegal relevance. Virchows Arch; 2007 Sep;451(3):623-47
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  • [Title] Melanocytic nevi simulant of melanoma with medicolegal relevance.
  • A group of melanocytic benign nevi are prone to be misdiagnosed as nodular or superficial spreading melanoma.
  • This review illustrates the most frequent forms of these nevi in direct comparison with their malignant morphologic counterparts.
  • The nevi are: hyper-cellular form of common nevus to be distinguished from nevoid melanoma, Spitz nevus (vs spitzoid melanoma), Reed nevus (vs melanoma with features of Reed nevus), cellular atypical blue nevus (vs melanoma on blue nevus), acral nevus (vs acral melanoma), Clark dysplastic nevus (vs superficial spreading melanoma), desmoplastic nevi (vs desmoplastic melanoma), benign proliferative nodules in congenital nevi (vs melanoma on congenital nevi), epithelioid blue nevus (vs animal type melanoma) and regressed nevus (vs regressed melanoma).
  • [MeSH-major] Liability, Legal. Melanoma / pathology. Nevus, Pigmented / pathology. Pathology / legislation & jurisprudence. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Child, Preschool. Diagnosis, Differential. Dysplastic Nevus Syndrome / pathology. Humans. Infant. Infant, Newborn. Neoplasms, Second Primary / pathology. Nevus / congenital. Nevus / pathology. Nevus, Blue / pathology. Nevus, Spindle Cell / pathology

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  • (PMID = 17653760.001).
  • [ISSN] 0945-6317
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 161
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59. Meleti M, Mooi WJ, van der Waal I: Oral malignant melanoma associated with pseudoepitheliomatous hyperplasia. Report of a case. J Cutan Pathol; 2006 Apr;33(4):331-3
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  • [Title] Oral malignant melanoma associated with pseudoepitheliomatous hyperplasia. Report of a case.
  • BACKGROUND: Pseudoepitheliomatous hyperplasia (PEH), a histological mimic of squamous cell carcinoma, is an exuberant reactive epithelial proliferation that may be induced by a variety of infectious, traumatic, inflammatory and neoplastic conditions of the skin and mucous membranes.
  • PEH has been described in association with Spitz nevi and intramucosal nevi but not with oral malignant melanoma.
  • METHODS AND RESULTS: A case of PEH in malignant melanoma of the palate in a 46-year-old female patient has been described.
  • CONCLUSIONS: PEH associated with oral malignant melanoma is apparently very rare and most likely originates from the surface epithelium.
  • This is in contrast with PEH in cutaneous melanoma where follicular or eccrine units have been suggested to be the origin.
  • [MeSH-major] Epithelium / pathology. Hyperplasia / pathology. Melanoma / diagnosis. Melanoma / pathology. Mouth Neoplasms / diagnosis. Mouth Neoplasms / pathology


60. Lee JB: Spitz nevus versus melanoma: limitation of the diagnostic methodology exposed. Eur J Dermatol; 2006 May-Jun;16(3):223-4
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  • [Title] Spitz nevus versus melanoma: limitation of the diagnostic methodology exposed.
  • [MeSH-major] Melanoma / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis. Skin Neoplasms / diagnosis


61. Yasuma A, Hara H, Hukuda N, Terui T: Usefulness of dermoscopy for diagnosing pigmented Spitz nevus occurring on the glabrous skin. J Eur Acad Dermatol Venereol; 2006 Nov;20(10):1362-3
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  • [Title] Usefulness of dermoscopy for diagnosing pigmented Spitz nevus occurring on the glabrous skin.
  • [MeSH-major] Dermoscopy. Nevus, Epithelioid and Spindle Cell / diagnosis. Skin / pathology. Skin Neoplasms / diagnosis

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  • (PMID = 17062078.001).
  • [ISSN] 0926-9959
  • [Journal-full-title] Journal of the European Academy of Dermatology and Venereology : JEADV
  • [ISO-abbreviation] J Eur Acad Dermatol Venereol
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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62. Beer TW: Reexcision perineural invasion: a mimic of malignancy. Am J Dermatopathol; 2006 Oct;28(5):423-5
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  • The presence of epithelium in the perineural space is typically associated with invasion by malignant tumors.
  • In this report, bland-appearing epithelium was identified in the perineural space associated with a dermal reparative reaction after removal of a melanoma in 4 patients.
  • After exclusion of possible squamous cell carcinoma and immunohistochemistry, a diagnosis of reexcision perineural invasion was made.
  • A lack of appreciation of the condition may lead to a misdiagnosis of malignancy, especially squamous cell carcinoma.
  • There may be increased recognition of reexcision perineural invasion with the rise in reexcisions that are being performed, with some surgeons reexcising Spitz nevi and dysplastic nevi, for example.
  • [MeSH-major] Melanoma / pathology. Nervous System Neoplasms / pathology. Skin Neoplasms / pathology

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  • [CommentIn] Am J Dermatopathol. 2007 Apr;29(2):221 [17414456.001]
  • [CommentIn] Am J Dermatopathol. 2007 Apr;29(2):221; author reply 221-2 [17414455.001]
  • (PMID = 17012918.001).
  • [ISSN] 0193-1091
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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63. Parente P, Coli A, Massi G, Mangoni A, Fabrizi MM, Bigotti G: Immunohistochemical expression of the glucose transporters Glut-1 and Glut-3 in human malignant melanomas and benign melanocytic lesions. J Exp Clin Cancer Res; 2008;27:34
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  • [Title] Immunohistochemical expression of the glucose transporters Glut-1 and Glut-3 in human malignant melanomas and benign melanocytic lesions.
  • This study was undertaken to assess the differential expression of Glut-1 and Glut-3 by benign and malignant melanocytic lesions.
  • METHODS: Immunohistochemical staining for Glut-1 and Glut-3 was performed on paraffin-embedded tissue sections prepared from melanocytic nevi (12 cases), Spitz nevi (12 cases) and primary cutaneous malignant melanomas (20 cases).
  • RESULTS: We observed immunoreactivity for Glut-1 in all melanocytic nevi, 9 of the 12 Spitz nevi and in 9 of the 20 malignant melanomas, whereas Glut-3 was expressed in all the melanocytic lesions, both benign and malignant.
  • Glut-1 was present in the majority of benign nevi, whereas its expression was downregulated in 55% of malignant melanomas.
  • Our results suggest that glucose transporter Glut-1 expression can significantly discriminate between human malignant melanoma and benign melanocytic nevi, and support the idea that additional mechanisms other than Glut-1 may contribute to glucose uptake in melanomas.
  • [MeSH-major] Glucose Transporter Type 1 / metabolism. Glucose Transporter Type 3 / metabolism. Melanoma / metabolism. Nevus, Epithelioid and Spindle Cell / metabolism
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Humans. Immunohistochemistry

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  • (PMID = 18764953.001).
  • [ISSN] 1756-9966
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Glucose Transporter Type 1; 0 / Glucose Transporter Type 3
  • [Other-IDs] NLM/ PMC2553059
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64. Egberts F, Kaehler KC, Brasch J, Schwarz T, Cerroni L, Hauschild A: Multiple skin metastases of malignant melanoma with unusual clinical and histopathologic features in an immunosuppressed patient. J Am Acad Dermatol; 2008 May;58(5):880-4
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  • [Title] Multiple skin metastases of malignant melanoma with unusual clinical and histopathologic features in an immunosuppressed patient.
  • Immunosuppressive regimens may have significant impact on the number of pigmented lesions and the clinical appearance of nevi.
  • A clinically inconspicuous mole was removed from the left flank and was considered to be a papillomatous nevus.
  • After 1 year, the patient developed multiple pigmented lesions over the entire body, which presented clinically as benign papillomatous nevi and histologically as atypical Spitz nevi.
  • Three months later melanoma metastases were removed from the patient's left axilla, which finally resulted in the death of the patient.
  • Thus, in retrospect, the eruptive pigmented lesions have to be considered as cutaneous melanoma metastases.
  • The atypical clinical and histopathologic appearance of the melanocytic lesions as well as the course of disease may have been influenced by the immunosuppression.
  • [MeSH-major] Immunosuppression / adverse effects. Melanoma / secondary. Nevus, Pigmented / pathology. Skin Neoplasms / secondary

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  • (PMID = 18258334.001).
  • [ISSN] 1097-6787
  • [Journal-full-title] Journal of the American Academy of Dermatology
  • [ISO-abbreviation] J. Am. Acad. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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65. Aida K, Monia K, Ahlem S, Dominique HT, Becima F, Sylvie F, Ridha KM: Agminated Spitz nevi arising on a nevus spilus after chemotherapy. Pediatr Dermatol; 2010 Jul-Aug;27(4):411-3
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  • [Title] Agminated Spitz nevi arising on a nevus spilus after chemotherapy.
  • Agminated Spitz nevus arising on a background of nevus spilus (NS) is a rare condition.
  • A 3-year-old boy presented 3 months after the onset of a chemotherapy for a vesico-prostatic rhabdomyosarcoma, multiple pigmented papulo-nodules located on the face, neck, chest wall, and the higher back.
  • These lesions have arose on a pre-existent large congenital histologically confirmed nevus spilus extending along the face, neck, the left shoulder and the left chest wall.
  • Histological examination of three excised nodules led to the diagnosis of Spitz nevus.
  • Our patient may have a high risk for melanoma since he has many criteria predisposing to this risk.
  • Some of these criteria are related to NS but we should also take into account the chemotherapy induction and the high number of Spitz nevi.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Nevus, Epithelioid and Spindle Cell / chemically induced. Prostatic Neoplasms / drug therapy. Rhabdomyosarcoma / drug therapy. Skin Neoplasms / chemically induced. Urinary Bladder Neoplasms / drug therapy


66. Requena C, Requena L, Sánchez-Yus E, Kutzner H, Llombart B, Sanmartín O, Botella-Estrada R, Nagore E, Serra C, Guillén C: Hypopigmented Reed nevus. J Cutan Pathol; 2008 Oct;35 Suppl 1:87-9
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  • [Title] Hypopigmented Reed nevus.
  • Reed nevus, also named pigmented spindle cell nevus, is a peculiar melanocytic nevus, now regarded as a variant of Spitz nevus by the majority of authors.
  • It is characterized by spindle-shaped melanocytes disposed in nests located in epidermis and papillary dermis.
  • It is usually heavily pigmented, and many melanophages may also be present.
  • Hypopigmented Reed nevus shows all the typical features of conventional pigmented spindle cell nevus, but it does not contain abundant melanin.
  • This variant of Reed nevus is poorly described in literature, so we report five cases of hypopigmented Reed nevus and discuss its clinical and histopathological features.
  • [MeSH-major] Hypopigmentation / pathology. Nevus, Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Arm / pathology. Child. Diagnosis, Differential. Female. Humans. Keratosis, Seborrheic / pathology. Leg / pathology. Lymphangioma / pathology. Male. Melanocytes / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Nevus, Pigmented / pathology

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  • [Copyright] Copyright Blackwell Munksgaard 2008.
  • (PMID = 18547345.001).
  • [ISSN] 1600-0560
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
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67. Zedek DC, McCalmont TH: Spitz Nevi, Atypical Spitzoid Neoplasms, and Spitzoid Melanoma. Surg Pathol Clin; 2009 Sep;2(3):497-510
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  • [Title] Spitz Nevi, Atypical Spitzoid Neoplasms, and Spitzoid Melanoma.
  • Spitz nevi and melanoma represent benign and malignant counterparts commonly coupled in the same differential diagnosis.
  • In this article, the clinical and histopathological attributes of Spitz nevi and spitzoid melanoma are reviewed.
  • Lesions that cannot be definitively classified based solely upon conventional microscopic criteria are referred to as atypical spitzoid neoplasms, which the authors view as a provisional diagnostic category rather than as a formal disease entity.

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  • [Copyright] Copyright © 2009. Published by Elsevier Inc.
  • (PMID = 26838535.001).
  • [ISSN] 1875-9181
  • [Journal-full-title] Surgical pathology clinics
  • [ISO-abbreviation] Surg Pathol Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Keywords] NOTNLM ; A typical spitzoid tumor / FISH / Genomic / Melanoma / Melanoma of childhood / Spitz nevus
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68. Sulit DJ, Guardiano RA, Krivda S: Classic and atypical Spitz nevi: review of the literature. Cutis; 2007 Feb;79(2):141-6
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  • [Title] Classic and atypical Spitz nevi: review of the literature.
  • Both classic and atypical Spitz nevi are uncommon melanocytic lesions usually presenting in children and adolescents.
  • The classic Spitz nevus typically is benign and has characteristic clinical and histologic features.
  • In contrast, the atypical Spitz nevus has an unknown clinical prognosis, and its clinical and histologic traits are loosely defined.
  • Melanoma can have similar features to both classic and atypical Spitz nevi and must be ruled out in all cases.
  • We review the literature on classic and atypical Spitz nevi, advances in differentiating both types of nevi from melanoma, and treatment options.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Diagnosis, Differential. Humans. Melanoma / pathology

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  • [CommentIn] Cutis. 2007 Sep;80(3):183; author reply 183 [17956003.001]
  • (PMID = 17388217.001).
  • [ISSN] 0011-4162
  • [Journal-full-title] Cutis
  • [ISO-abbreviation] Cutis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 38
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69. Magro CM, Yaniv S, Mihm MC: The superficial atypical Spitz tumor and malignant melanoma of superficial spreading type arising in association with the superficial atypical Spitz tumor: A distinct form of dysplastic Spitzoid nevomelanocytic proliferation. J Am Acad Dermatol; 2009 May;60(5):814-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The superficial atypical Spitz tumor and malignant melanoma of superficial spreading type arising in association with the superficial atypical Spitz tumor: A distinct form of dysplastic Spitzoid nevomelanocytic proliferation.
  • Spitzoid lesions are diagnostically problematic because of a deceptive morphology and indeterminate behavior.
  • The most problematic are atypical Spitz tumors whereby distinction from melanoma may be difficult.
  • We have designated this lesion as the superficial atypical Spitz tumor and have encountered 27 cases.
  • We believe that these lesions overlap histomorphologically with higher-grade dysplastic nevi and de novo intraepidermal epithelioid melanocytic dysplasia.
  • We identified 19 additional cases that appear to represent transition into malignant melanoma of superficial spreading type arising in a background of the superficial atypical Spitz tumor.
  • In conclusion, there exists a distinct subset of Spitz tumors that we designate as the superficial atypical Spitz tumor in which there is inherent dysplasia including lesions that evolve into melanoma of superficial spreading type.
  • [MeSH-major] Melanoma / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Child. Female. Humans. Male. Middle Aged. Nevus, Epithelioid and Spindle Cell / pathology. Prospective Studies


70. Barnhill RL: The Spitzoid lesion: rethinking Spitz tumors, atypical variants, 'Spitzoid melanoma' and risk assessment. Mod Pathol; 2006 Feb;19 Suppl 2:S21-33
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  • [Title] The Spitzoid lesion: rethinking Spitz tumors, atypical variants, 'Spitzoid melanoma' and risk assessment.
  • Although much remains to be learned about Spitzoid lesions, there is increasing evidence that these tumors may be a type of melanocytic neoplasm distinct from conventional melanocytic nevi and malignant melanoma.
  • Acknowledging the peculiar nature of Spitzoid lesions, the author prefers the term Spitz tumor rather than 'Spitz nevus' (except perhaps for the most typical lesions) and argues against using the term 'Spitzoid melanoma' until more information is available to justify such a term.
  • (1) Spitz tumor without significant abnormality, (2) Spitz tumor with one or more atypical features (atypical Spitz tumor), including those judged to have indeterminate biological potential, and (3) malignant melanoma, rather than the two categories of 'Spitz nevus' and melanoma.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Diagnosis, Differential. Genes, ras / genetics. Humans. Immunohistochemistry. Ki-67 Antigen / analysis. Melanoma / genetics. Melanoma / metabolism. Melanoma / pathology. Mutation. Neoplasm Metastasis. Proto-Oncogene Proteins B-raf / genetics. Risk Assessment. S100 Proteins / analysis. Terminology as Topic

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  • (PMID = 16446713.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 0 / S100 Proteins; EC 2.7.11.1 / Proto-Oncogene Proteins B-raf
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71. Urso C, Gelli R, Borgognoni L, Tinacci G, Reali UM: Positive sentinel node biopsy in a 30-month-old boy with atypical Spitz tumour (Spitzoid melanoma). Histopathology; 2006 Jun;48(7):884-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Positive sentinel node biopsy in a 30-month-old boy with atypical Spitz tumour (Spitzoid melanoma).
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Sentinel Lymph Node Biopsy. Skin / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Antigens, Neoplasm. Humans. Immunohistochemistry. Infant. Male. Melanins / analysis. Melanoma-Specific Antigens. Neoplasm Proteins / analysis. S100 Proteins / analysis

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  • (PMID = 16722946.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Melanins; 0 / Melanoma-Specific Antigens; 0 / Neoplasm Proteins; 0 / S100 Proteins
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72. Magro CM, Crowson AN, Mihm MC Jr, Gupta K, Walker MJ, Solomon G: The dermal-based borderline melanocytic tumor: a categorical approach. J Am Acad Dermatol; 2010 Mar;62(3):469-79
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  • [Title] The dermal-based borderline melanocytic tumor: a categorical approach.
  • BACKGROUND: The borderline melanocytic tumor (BMT) is a morphologically and biologically indeterminate melanocytic proliferation manifesting worrisome architectural features and cytologic atypia exceeding that encountered in melanocytic nevi yet insufficient to warrant designation as melanoma.
  • (2) the atypical Spitz tumor (AST);.
  • (3) pigmented epithelioid melanocytoma (PEM); and (4) BMT arising in a deep penetrating nevus (B-DPN).
  • One patient, a 36-year-old man, died of disease, while the others are alive and well.
  • In the one death attributable to widespread metastatic disease, the lesion was initially interpreted as a deep penetrating nevus; however, retrospective review revealed features compatible with a B-DPN; the review was prompted by a recurrence that was morphologically compatible with a Clark level V malignant melanoma, reflecting clinical and morphologic progression.
  • Molecular studies to further explore the biologic commonality with melanoma were not performed.
  • CONCLUSION: The dermal variant of BMT is a tumor of younger adults and children that can be associated with lymph node disease and a potential for morphologic and biologic progression when inadequately treated.
  • [MeSH-major] Melanoma / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Female. Humans. Lymph Nodes / pathology. Lymphatic Metastasis / pathology. Male. Melanocytes / pathology. Middle Aged. Nevus, Epithelioid and Spindle Cell / pathology. Nevus, Pigmented / classification. Nevus, Pigmented / pathology. Sentinel Lymph Node Biopsy


73. Brunetti B, Nino M, Sammarco E, Scalvenzi M: Spitz naevus: a proposal for management. J Eur Acad Dermatol Venereol; 2005 May;19(3):391-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spitz naevus: a proposal for management.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 15857482.001).
  • [ISSN] 0926-9959
  • [Journal-full-title] Journal of the European Academy of Dermatology and Venereology : JEADV
  • [ISO-abbreviation] J Eur Acad Dermatol Venereol
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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74. Busam KJ, Pulitzer M: Sentinel lymph node biopsy for patients with diagnostically controversial Spitzoid melanocytic tumors? Adv Anat Pathol; 2008 Sep;15(5):253-62
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  • [Title] Sentinel lymph node biopsy for patients with diagnostically controversial Spitzoid melanocytic tumors?
  • The distinction of a Spitz nevus from melanoma can be very difficult.
  • Pathologists may disagree on whether a Spitzoid melanocytic proliferation is benign or malignant, or acknowledge uncertainty about the diagnosis.
  • As long as melanoma is suspected or strongly considered, a clinical management plan is often adopted as if the patient had melanoma, which may include sentinel lymph node (SLN) biopsy for staging.
  • The findings of the sentinel node may resolve the diagnostic controversy about the primary tumor, but there is also the risk for more diagnostic confusion, uncertainty, and errors.
  • We review the arguments in favor and against SLN biopsy for patients with diagnostically controversial Spitzoid melanocytic tumors, summarize current experience, and illustrate diagnostic pitfalls.
  • [MeSH-major] Melanoma / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis. Sentinel Lymph Node Biopsy. Skin Neoplasms / diagnosis

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  • (PMID = 18724099.001).
  • [ISSN] 1533-4031
  • [Journal-full-title] Advances in anatomic pathology
  • [ISO-abbreviation] Adv Anat Pathol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 57
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75. Ahmadi N, Davison SP, Kauffman CL: Melanocytic nevi with Spitz differentiation: diagnosis and management. Laryngoscope; 2010 Dec;120(12):2385-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Melanocytic nevi with Spitz differentiation: diagnosis and management.
  • OBJECTIVES: Melanocytic proliferations with Spitz differentiation present a difficult clinicopathologic dilemma, as their spectrum ranges from benign to malignant.
  • Distinct entities include Spitz nevus, atypical Spitz nevus, and Spitzoid melanoma.
  • Their histopathologic differentiation can be challenging, and cases of Spitzoid melanoma initially diagnosed as benign Spitz nevi are reported in the literature.
  • The goal of this article is to discuss the diagnostic tools (including comparative genomic hybridization), which may be helpful in differentiating benign Spitz nevi from malignant melanoma with Spitzoid features, and to propose an appropriate management strategy for each entity.
  • METHODS: Medical records of patients referred for suspicious nevi were reviewed.
  • RESULTS: Four patients with three distinct diagnoses involving Spitz differentiation were identified.
  • CONCLUSIONS: Otolaryngologists, plastic surgeons and dermatopathologists will encounter patients who have melanocytic lesions with Spitz differentiation at some point in their career.
  • We believe that a team approach between the surgeon and the dermatopathologist is crucial when diagnosing and managing patients with Spitz lesions.
  • [MeSH-major] Neoplasm Staging / methods. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Arm. Back. Biopsy. Cell Differentiation. Child. Child, Preschool. Dermis / pathology. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Male. Retrospective Studies. Sentinel Lymph Node Biopsy

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  • (PMID = 21072755.001).
  • [ISSN] 1531-4995
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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76. Troxel DB: An insurer's perspective on error and loss in pathology. Arch Pathol Lab Med; 2005 Oct;129(10):1234-6
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  • Pathology claim severity is high, especially for claims involving a misdiagnosis of melanoma or a false-negative Papanicolaou test.
  • Fifty-seven percent of claims involved the following 5 categories: breast specimens, melanoma, Papanicolaou smears, gynecologic specimens, and operational error.
  • CONCLUSION: A false-negative diagnosis of melanoma is the single most common reason for filing a malpractice claim against a pathologist.
  • Nearly one third of misdiagnoses involve melanoma misdiagnosed as Spitz nevus, "dysplastic" nevus, spindle cell squamous carcinoma, atypical fibroxanthoma, and dermatofibroma.
  • [MeSH-minor] Humans. Melanoma / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 16196510.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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77. Abdou AG, Hammam MA, Farargy SE, Farag AG, El Shafey EN, Farouk S, Elnaidany NF: Diagnostic and prognostic role of galectin 3 expression in cutaneous melanoma. Am J Dermatopathol; 2010 Dec;32(8):809-14
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  • [Title] Diagnostic and prognostic role of galectin 3 expression in cutaneous melanoma.
  • Many of the histopathologic criteria used to diagnose melanoma overlap with atypical but otherwise benign naevi such as dysplastic or Spitz naevi.
  • Galectin-3 is a member of the galectin gene family and is expressed at elevated levels in a variety of neoplastic cell types.
  • The aim of the present study was to investigate the diagnostic value of galectin-3 expression compared with homatropine methyle bromide-45(HMB-45) (one of the established and widely used immunohistochemical melanocytic markers) together with assessment of its prognostic value in melanoma lesions.
  • This study was carried out on 21 cases of melanoma and 20 benign pigmented naevi.
  • Galectin-3 was expressed in all the examined benign and malignant melanocytic lesions.
  • This pattern tended to be associated with thick melanoma (P = 0.08) and reduced survival (P = 0.22).
  • The intensity of galectin-3 assessed by H-score was significantly of higher values in malignant lesions compared with benign lesions (P < 0.0001).
  • The best cut-off value for discrimination between benign and malignant melanocytic lesions was 295 with 95% sensitivity, 70% specificity, and 83% accuracy.
  • The diagnostic power of galectin-3 in distinguishing between benign and malignant melanocytic lesions relies on the pattern and the intensity of its expression.
  • The nucleocytoplasmic pattern of galectin-3 expression carries greater probability of a malignant phenotype and a poor prognostic impact on patients' outcome.
  • [MeSH-major] Biomarkers, Tumor / analysis. Galectin 3 / analysis. Melanocytes / chemistry. Melanoma / chemistry. Nevus, Pigmented / chemistry. Skin Neoplasms / chemistry. Tropanes / analysis


78. Zangari A, Bernardini ML, Tallarico R, Ilari M, Giangiacomi M, Offidani AM, Martino A: Indications for excision of nevi and melanoma diagnosed in a pediatric surgical unit. J Pediatr Surg; 2007 Aug;42(8):1412-6
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  • [Title] Indications for excision of nevi and melanoma diagnosed in a pediatric surgical unit.
  • BACKGROUND/PURPOSE: Childhood melanoma is rare but increasing in incidence.
  • The purpose of this study is to discuss surgical indications of nevi and diagnosis of melanoma in a pediatric surgical unit.
  • METHODS: Data relative to the patients who underwent removal of nevi in our pediatric surgical unit from 1999 to 2005 were reviewed to identify indications, histology, and melanoma occurrence.
  • RESULTS: The most frequent indication was atypical nevus.
  • Compound nevus was the most common finding, followed by congenital and Spitz nevi.
  • Melanoma was diagnosed in 3 excised nevi, and in 1 case it occurred as a metastatic disease.
  • CONCLUSIONS: Our data showed a pattern of indications for surgery similar to that described in the literature, with a high detection rate of melanoma, nonetheless showing that some rare conditions may delay diagnosis.
  • [MeSH-major] Melanoma / diagnosis. Nevus / diagnosis. Skin Neoplasms / diagnosis. Skin Neoplasms / surgery

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  • (PMID = 17706506.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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79. Urso C: Melanocytic lesions, Spitz tumors, and Don Ferrante's logic. Am J Dermatopathol; 2007 Oct;29(5):491-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Melanocytic lesions, Spitz tumors, and Don Ferrante's logic.
  • [MeSH-major] Melanoma / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis. Nevus, Pigmented / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 17890925.001).
  • [ISSN] 0193-1091
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Letter
  • [Publication-country] United States
  • [Chemical-registry-number] EC 2.7.11.1 / BRAF protein, human; EC 2.7.11.1 / Proto-Oncogene Proteins B-raf
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80. Fabrizi G, Pennacchia I, Pagliarello C, Massi G: Sclerosing nevus with pseudomelanomatous features. J Cutan Pathol; 2008 Nov;35(11):995-1002
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sclerosing nevus with pseudomelanomatous features.
  • BACKGROUND: Among the pigmented lesions with a central area of scar, we found a group of cases histologically characterized by striking architectural alteration of the melanocytic component, but with no cytological atypia and mitotically quiescent.
  • METHODS: We selected 19 of these melanocytic neoplasms that had the following characteristics: (a) a clinically evident whitish central area suggestive of regression (with no history of a previous surgical procedure or trauma), (b) histological features of fibrous scar-like tissue at the center of the lesion, (c) the presence of large, confluent and unusually shaped melanocytic nests at the dermoepidermal junction and in the dermis, (d) a pagetoid spread of melanocytes above the epidermal basal layer and (e) remnants of nevus tissue at the border of the scar.
  • Histologically, these neoplasms have important similarities with the so-called recurrent nevus, nevi on lichen sclerosus and nevi developed during or following cutaneous inflammatory and sclerosing processes.
  • The origin of the scar in each case was obscure but was probably related to minor unnoticed trauma or to chronic friction on a nevus.
  • In few cases, the fibrosis was probably the result of partial regression of the nevus or a sequel to folliculitis.
  • The pseudomelanomatous features appear to be related to the presence of the scar, as already reported for nevi that are involved in fibrotic or scarring processes.
  • In our study, the nevi involved in the fibrotic process were congenital nevi and common or dysplastic nevi.
  • One case was a Spitz nevus.
  • CONCLUSIONS: From our data we concluded that, despite their worrisome clinical and histological aspect, the lesions described in this case series were most probably benign melanocytic nevi, involved by a fibrotic process combined with pseudomelanomatous proliferation.
  • The lack of cytological atypia, mitoses and expansive nodules allowed us to differentiate these lesions from regressing melanomas.
  • [MeSH-major] Melanocytes / pathology. Nevus, Pigmented / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Cell Proliferation. Cicatrix / pathology. Female. Humans. Male. Middle Aged. Sclerosis. Young Adult

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  • [CommentIn] J Cutan Pathol. 2009 Aug;36(8):913-5; author reply 916 [19586505.001]
  • (PMID = 18537860.001).
  • [ISSN] 1600-0560
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Denmark
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81. Polat M, Topcuoglu MA, Tahtaci Y, Hapa A, Yilmaz F: Spitz nevus of the genital mucosa. Indian J Dermatol Venereol Leprol; 2009 Mar-Apr;75(2):167-9
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  • [Title] Spitz nevus of the genital mucosa.
  • Dermatological examination of the patient was performed and a pigmented lesion was found on the inner surface of the labium majus of the mucosa.
  • The patient was diagnosed as Spitz nevus on the basis of clinical and histopathological findings.
  • Our case is probably the first reported case of Spitz nevus localized to the genital mucosa in the English literature.
  • [MeSH-major] Genital Diseases, Female / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 19293505.001).
  • [ISSN] 0973-3922
  • [Journal-full-title] Indian journal of dermatology, venereology and leprology
  • [ISO-abbreviation] Indian J Dermatol Venereol Leprol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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82. Zalaudek I, Bonifazi E, Ferrara G, Argenziano G: Keratoacanthomas and spitz tumors: are they both 'self-limiting' variants of malignant cutaneous neoplasms? Dermatology; 2009;219(1):3-6
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  • [Title] Keratoacanthomas and spitz tumors: are they both 'self-limiting' variants of malignant cutaneous neoplasms?
  • [MeSH-major] Keratoacanthoma / pathology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 19372640.001).
  • [ISSN] 1421-9832
  • [Journal-full-title] Dermatology (Basel, Switzerland)
  • [ISO-abbreviation] Dermatology (Basel)
  • [Language] eng
  • [Publication-type] Editorial; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 26
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83. Gow KW, Rapkin LB, Olson TA, Durham MM, Wyly B, Shehata BM: Sentinel lymph node biopsy in the pediatric population. J Pediatr Surg; 2008 Dec;43(12):2193-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Sentinel lymph node biopsy was performed for 10 sarcomas (5 synovial, 3 rhabdomyosarcoma, 1 epitheliod, 1 other); 9 skin neoplasms (4 melanomas, 3 Spitz nevi, 2 melanocytomas); and 1 acinic cell carcinoma.
  • Of 20 patients, 5 (25%) had metastatic disease (4 skin neoplasms and 1 sarcoma).
  • [MeSH-major] Lymphatic Metastasis / diagnosis. Melanoma / secondary. Sarcoma / secondary. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adolescent. Carcinoma, Acinar Cell / diagnosis. Carcinoma, Acinar Cell / secondary. Child. Child, Preschool. Coloring Agents. Female. Humans. Hypnotics and Sedatives / administration & dosage. Intraoperative Care. Male. Radiopharmaceuticals. Retrospective Studies. Rosaniline Dyes. Skin Neoplasms / pathology. Technetium Tc 99m Sulfur Colloid. Young Adult

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  • (PMID = 19040933.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Coloring Agents; 0 / Hypnotics and Sedatives; 0 / Radiopharmaceuticals; 0 / Rosaniline Dyes; 39N9K8S2A4 / iso-sulfan blue; 556Q0P6PB1 / Technetium Tc 99m Sulfur Colloid
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84. Kim YC, Do JE, Bang D, Cho BK, Cho KH, Choi JC, Kim MB, Kim MH, Kim SY, Kim SN, Lee JH, Lee SJ, Shin DH, Shin JH, Son SJ, Suh KS, Yoon TY, Park CK: Spitz naevus is rare in Korea. Clin Exp Dermatol; 2010 Mar;35(2):135-9
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  • [Title] Spitz naevus is rare in Korea.
  • BACKGROUND: Spitz naevi have not been widely studied in Asians.
  • AIM: To compare the epidemiology and clinicopathological features of Spitz naevi in Koreans with lesions in western countries.
  • METHODS: In total, 80 Spitz naevi in 77 patients diagnosed over 10 years at 17 university hospitals in Korea were analysed.
  • RESULTS: The relative incidence of Spitz naevus vs. MM was 1 vs. 10.9.
  • In most patients (75%) the Spitz naevi had been present for > 6 months.
  • CONCLUSION: Spitz naevus is rare in Korea.
  • The lesions were more commonly larger, pigmented, and of the dermal type than reported in western countries.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Biomarkers, Tumor. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Infant. Korea / epidemiology. Male. Melanoma / epidemiology. Melanoma / pathology. Middle Aged. Young Adult

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  • (PMID = 19594767.001).
  • [ISSN] 1365-2230
  • [Journal-full-title] Clinical and experimental dermatology
  • [ISO-abbreviation] Clin. Exp. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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85. Park JW, Namkoong S, Chung J, Jung KE, Oh SA, Cinn YW, Kim MH: A case of eccrine spiradenoma in a patient with neurofibromatosis. Ann Dermatol; 2010 May;22(2):191-3
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  • Neurofibromatosis is a systemic hereditary disorder with varied manifestations in bone, soft tissue, the nervous system and skin.
  • Some benign or malignant tumors such as juvenile xanthogranuloma, pheochromocytoma, and malignant melanoma can accompany neurofibromatosis.
  • Eccrine spiradenoma is a benign uncommon neoplasm of skin adnexa.

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  • [Cites] Arch Dermatol. 1990 Aug;126(8):1051-6 [2166484.001]
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  • (PMID = 20548911.001).
  • [ISSN] 2005-3894
  • [Journal-full-title] Annals of dermatology
  • [ISO-abbreviation] Ann Dermatol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2883423
  • [Keywords] NOTNLM ; Eccrine spiradenoma / Neurofibromatosis
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86. Hilliard NJ, Krahl D, Sellheyer K: p16 expression differentiates between desmoplastic Spitz nevus and desmoplastic melanoma. J Cutan Pathol; 2009 Jul;36(7):753-9
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  • [Title] p16 expression differentiates between desmoplastic Spitz nevus and desmoplastic melanoma.
  • BACKGROUND: Loss of p16 in melanomas reflects worse outcomes for patients.
  • It is associated with depth of invasion, ulceration, vascular invasion, lymph node metastases, metastases, recurrence of melanoma and decreased 5-year survival.
  • Desmoplastic melanoma is an insidious malignant melanoma subtype that commonly occurs on sun-damaged skin of the head and neck area in elderly patients.
  • The diagnostic conundrum occurs with confusion of desmoplastic melanoma with scars, hyalinizing blue nevi, desmoplastic Spitz nevi and diffuse neurofibromas.
  • METHODS: The present study uses immunohistochemistry with a p16 antibody to differentiate desmoplastic Spitz nevi (n = 15 cases) from desmoplastic melanomas (n = 11).
  • To date, no other studies have been published defining the expression pattern of p16 in desmoplastic melanoma.
  • RESULTS: 81.8% of desmoplastic melanomas were negative for p16 and 18.2% were only weakly stained.
  • In contrast, all desmoplastic Spitz nevi were moderately to strongly positive for p16.
  • CONCLUSIONS: The staining pattern for p16 in desmoplastic melanomas and Spitz nevi in conjunction with the histopathologic features, S100 staining, Ki67 proliferation index and clinical scenario may aid in the difficult differential diagnosis between these two entities.
  • [MeSH-major] Cyclin-Dependent Kinase Inhibitor Proteins / biosynthesis. Gene Expression Regulation, Neoplastic. Melanoma / metabolism. Melanoma / pathology. Nevus, Epithelioid and Spindle Cell / metabolism. Nevus, Epithelioid and Spindle Cell / pathology
  • [MeSH-minor] Adult. Cell Proliferation. Diagnosis, Differential. Female. Humans. Ki-67 Antigen / biosynthesis. Lymphatic Metastasis. Male. Middle Aged

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  • [Copyright] (c) 2009 John Wiley & Sons A/S.
  • (PMID = 19519606.001).
  • [ISSN] 1600-0560
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Cyclin-Dependent Kinase Inhibitor Proteins; 0 / Ki-67 Antigen
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87. Pellacani G, Longo C, Ferrara G, Cesinaro AM, Bassoli S, Guitera P, Menzies SW, Seidenari S: Spitz nevi: In vivo confocal microscopic features, dermatoscopic aspects, histopathologic correlates, and diagnostic significance. J Am Acad Dermatol; 2009 Feb;60(2):236-47
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  • [Title] Spitz nevi: In vivo confocal microscopic features, dermatoscopic aspects, histopathologic correlates, and diagnostic significance.
  • BACKGROUND: Spitz nevi are benign melanocytic tumors, sometimes misdiagnosed as malignant melanoma (MM).
  • OBJECTIVE: We sought identification of characteristic in vivo microscopic features of Spitz nevi, their histopathologic correlates, and diagnostic usefulness.
  • METHODS: Forty Spitz nevi were studied by in vivo confocal microscopy and dermatoscopy, evaluating histopathologic correlates, and compared with 40 MMs and 40 Clark nevi.
  • RESULTS: Some histologic aspects characteristic for Spitz nevus diagnosis were correlated with confocal features, comprising some that can be useful for atypical Spitz nevus classification.
  • The most striking features for differentiating Spitz nevi from MMs were the presence of sharp border cut-off, junctional nests, and melanophages.
  • CONCLUSION: Confocal and dermatoscopic examination enabled the identification of different Spitz categories with different histologic substrates.
  • [MeSH-major] Dermoscopy. Melanoma / pathology. Microscopy, Confocal. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Dermis / pathology. Diagnosis, Differential. Dysplastic Nevus Syndrome / pathology. Epidermis / pathology. Humans

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  • (PMID = 19091443.001).
  • [ISSN] 1097-6787
  • [Journal-full-title] Journal of the American Academy of Dermatology
  • [ISO-abbreviation] J. Am. Acad. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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88. Erickson LA, Letts GA, Shah SM, Shackelton JB, Duncan LM: TRPM1 (Melastatin-1/MLSN1) mRNA expression in Spitz nevi and nodular melanomas. Mod Pathol; 2009 Jul;22(7):969-76
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  • [Title] TRPM1 (Melastatin-1/MLSN1) mRNA expression in Spitz nevi and nodular melanomas.
  • The transient receptor potential cation channel, subfamily M, member 1 (TRPM1/Melastatin-1/MLSN-1) expression has been shown to have prognostic utility in the evaluation of primary cutaneous melanoma.
  • We analyzed a series of spindled and epithelioid cell nevi (Spitz) and primary cutaneous nodular melanomas to determine whether the expression of TRPM1 mRNA may be useful in distinguishing between Spitz nevi and nodular melanomas and to further examine the patterns of TRPM1 mRNA expression in cutaneous melanocytic proliferations.
  • Formalin-fixed, paraffin-embedded tissues from 95 Spitz nevi and 33 nodular melanomas were analyzed for the expression of TRPM1 mRNA by in situ hybridization using (35)S-labeled riboprobes.
  • Ubiquitous melanocytic expression of TRPM1 mRNA was observed in 56 of 95 (59%) Spitz nevi and 4 of 33 (12%) nodular melanomas.
  • Diffusely scattered loss of TRPM1 mRNA was identified in 38 of 95 (40%) Spitz nevi and 2 of 33 (6%) nodular melanomas.
  • Regional loss of the TRPM1 mRNA expression by a significant subset of dermal tumor cells or a complete absence of TRPM1 expression by the dermal tumor was identified in 27 of 33 (82%) nodular melanomas, but only 1 of 95 (1%) Spitz nevi.
  • These findings suggest that the pattern of TRPM1 mRNA expression may be helpful in the differentiation of Spitz nevi and nodular melanomas.
  • Of the 16 patients who experienced metastasis, 15 (94%) had primary tumors that displayed reduced MLSN mRNA expression by all or a part of the dermal tumor.
  • [MeSH-major] Biomarkers, Tumor / genetics. Gene Expression Regulation, Neoplastic. Melanoma / genetics. Nevus, Epithelioid and Spindle Cell / genetics. Skin Neoplasms / genetics. TRPM Cation Channels / genetics

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  • (PMID = 19396153.001).
  • [ISSN] 1530-0285
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / TRPM Cation Channels; 0 / TRPM1 protein, human
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89. Pinheiro AM, Pereira GA, Amorin AG, Varella TC, Friedman H: Spitz nevus: a case report and the use of dermoscopy. An Bras Dermatol; 2010 Jul-Aug;85(4):555-7
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  • [Title] Spitz nevus: a case report and the use of dermoscopy.
  • The Spitz nevus is a benign melanocytic lesion with clinical and histopathological features similar to those of melanoma.
  • In Spitz nevus, the most common dermoscopic finding is a starburst-like pattern, followed by globular and atypical patterns.
  • [MeSH-major] Dermoscopy. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 20944920.001).
  • [ISSN] 1806-4841
  • [Journal-full-title] Anais brasileiros de dermatologia
  • [ISO-abbreviation] An Bras Dermatol
  • [Language] eng; por
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
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90. Urso C, Borgognoni L, Saieva C, Ferrara G, Tinacci G, Begliomini B, Reali UM: Sentinel lymph node biopsy in patients with "atypical Spitz tumors." A report on 12 cases. Hum Pathol; 2006 Jul;37(7):816-23
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  • [Title] Sentinel lymph node biopsy in patients with "atypical Spitz tumors." A report on 12 cases.
  • The distinction between Spitz nevus and melanoma is currently possible, applying a set of definite histological criteria.
  • However, in certain lesions deviating from the stereotypical morphology of classic Spitz nevi ("atypical Spitz tumors"), the differentiation between benign and malignant cases appears problematic because objective criteria for a reliable diagnosis are lacking.
  • We report the clinicopathologic findings of 12 patients with atypical Spitz tumors, who underwent sentinel node biopsy.
  • All the tumors, composed of spindle and/or epithelioid cells, histologically showed features referable to Spitz nevi mixed to features generally found in malignant melanomas.
  • Among the patients with positive sentinel node, two showed minimal nodal involvements; one patient showed additional tumor deposits in one nonsentinel regional node.
  • All patients are alive and free of disease with a follow-up of 2 to 90 months (mean, 26.3 months).
  • [MeSH-major] Melanoma / diagnosis. Nevus, Epithelioid and Spindle Cell / diagnosis. Sentinel Lymph Node Biopsy. Skin Neoplasms / diagnosis

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  • [CommentIn] Hum Pathol. 2006 Jul;37(7):779-80 [16784974.001]
  • (PMID = 16784980.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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91. Song JY, Kwon JA, Park CJ: A case of Spitz nevus with multiple satellite lesions. J Am Acad Dermatol; 2005 Feb;52(2 Suppl 1):48-50
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  • [Title] A case of Spitz nevus with multiple satellite lesions.
  • Spitz nevus is a benign melnocytic lesion with many histologic similarities to malignant melanoma.
  • To our knowledge, a Spitz nevus with multiple satellite lesions has not been reported.
  • This paper reports a case of Spitz nevus with multiple satellite lesions on the abdomen of a 19-year-old Korean woman.
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology

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  • (PMID = 15692514.001).
  • [ISSN] 1097-6787
  • [Journal-full-title] Journal of the American Academy of Dermatology
  • [ISO-abbreviation] J. Am. Acad. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 24
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92. Roaten JB, Partrick DA, Pearlman N, Gonzalez RJ, Gonzalez R, McCarter MD: Sentinel lymph node biopsy for melanoma and other melanocytic tumors in adolescents. J Pediatr Surg; 2005 Jan;40(1):232-5
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  • [Title] Sentinel lymph node biopsy for melanoma and other melanocytic tumors in adolescents.
  • BACKGROUND/PURPOSE: Melanoma is rare, accounting for only 1% of all pediatric malignancies.
  • The management of pediatric melanoma is controversial but largely parallels that of an adult occurrence.
  • Sentinel lymph node biopsy (SLNBX) has become a standard of care for adults with melanoma, but the role of this procedure in the staging of pediatric patients remains to be established.
  • METHODS: A retrospective review of patients younger than 21 years (N = 20) undergoing SLNBX for melanoma or other melanocytic skin lesions at the University of Colorado Health Science Center between 1996 and 2003 was conducted.
  • As in adults, the sentinel node status correlates with primary tumor depth.
  • At 33 months median follow-up, all patients were disease free.
  • CONCLUSIONS: Sentinel lymph node biopsy can be successfully and safely performed in pediatric patients for melanoma and atypical nevi.
  • Completion lymph node dissection for microscopic disease is a morbid procedure with uncertain benefit to pediatric or adult patients with a positive SLNBX result.
  • Long-term follow-up data are needed before SLNBX can become a standard of care in pediatric melanoma or as a diagnostic tool to distinguish the atypical Spitz nevus from melanoma.
  • [MeSH-major] Melanoma / pathology. Nevus, Pigmented / pathology. Sentinel Lymph Node Biopsy. Skin Neoplasms / pathology

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  • (PMID = 15868590.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / K12 CA86913
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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93. Tena Sanabria ME, Herrera Sánchez D, Hernández López J, Huicochea Montiel JC, Rodríguez A: [Li-Fraumeni familial cancer syndrome: case report and review of the literature]. Acta Ortop Mex; 2007 Mar-Apr;21(2):99-104
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  • [Transliterated title] Síndrome de Li Fraumeni. Cáncer familiar comunicación de un caso y revisión de la literatura.
  • INTRODUCTION: Multiple familial cancer is a rare entity as is also Li-Fraumeni Syndrome (LFS), which involves a mutation in the germ cell line of Tp53 suppresor gene that is expressed in chromosome 17p13.1 and occurs as an autosomal dominant condition.
  • CLINICAL CASE: Family history: maternal grandfather had melanoma and maternal aunt had osteoblastic osteosarcoma of the left distal femur.
  • Eight-and-a-half year-old child with a history of a CNS tumor (choroid plexus carcinoma) and two years later, a melanoma (Spitz nevus).
  • We suggest that the questioning of patients with cancer be aimed at finding out the family history of neoplasias.

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  • (PMID = 17695766.001).
  • [ISSN] 2306-4102
  • [Journal-full-title] Acta ortopédica mexicana
  • [ISO-abbreviation] Acta Ortop Mex
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Mexico
  • [Number-of-references] 15
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94. Florell SR, Bowen AR, Hanks AN, Murphy KJ, Grossman D: Proliferation, apoptosis, and survivin expression in a spectrum of melanocytic nevi. J Cutan Pathol; 2005 Jan;32(1):45-9
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  • [Title] Proliferation, apoptosis, and survivin expression in a spectrum of melanocytic nevi.
  • The apoptosis inhibitor survivin is expressed in melanoma and non-melanoma skin cancers and benign keratinocytic lesions.
  • Its expression has not been studied in melanocytic nevi.
  • OBJECTIVE: We determined the expression pattern of survivin in benign melanocytic nevi in comparison to markers of proliferation and apoptosis.
  • METHODS: Six cases of each of the following melanocytic nevi were retrieved from a dermatopathology archive: compound dysplastic nevus, intradermal nevus, compound nevus, neurotized intradermal nevus, and Spitz nevus.
  • Apoptotic and proliferation indices were calculated by counting immunoreactive cells in terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling and proliferating cell nuclear antigen immunostained sections, respectively.
  • RESULTS: All nevi, regardless of histologic type, expressed survivin.
  • The apoptotic rate was low for dysplastic, compound, and Spitz nevi, and apoptotic cells were not identified in any neurotized nevus.
  • The proliferative index was highest for Spitz nevi, while all other nevi demonstrated rare positive cells.
  • CONCLUSIONS: Survivin is consistently expressed in benign melanocytic lesions, while apoptotic cells are rarely identified, suggesting the dysregulation of apoptotic pathways with the accumulation of cells in these neoplasms.

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  • (PMID = 15660660.001).
  • [ISSN] 0303-6987
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] ENG
  • [Grant] United States / NIAMS NIH HHS / AR / AR050102-02; United States / NIAMS NIH HHS / AR / K08 AR048618; United States / NCRR NIH HHS / RR / K23RR17525; United States / NCRR NIH HHS / RR / K23 RR017525; United States / NIAMS NIH HHS / AR / R01 AR050102; United States / NIAMS NIH HHS / AR / R01 AR050102-02; United States / NIAMS NIH HHS / AR / KO8AR48618
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Biomarkers, Tumor; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins; 0 / Neoplasm Proteins; 0 / RNA, Messenger
  • [Other-IDs] NLM/ NIHMS44268; NLM/ PMC2292117
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95. Ferrara G, Zalaudek I, Savarese I, Scalvenzi M, Argenziano G: Pediatric atypical spitzoid neoplasms: a review with emphasis on 'red' ('spitz') tumors and 'blue' ('blitz') tumors. Dermatology; 2010;220(4):306-10
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  • [Title] Pediatric atypical spitzoid neoplasms: a review with emphasis on 'red' ('spitz') tumors and 'blue' ('blitz') tumors.
  • BACKGROUND: The diagnosis of pediatric atypical Spitz nevus/tumors (pASNT) is an emerging challenge in clinical dermatology and dermatopathology.
  • RESULTS: While Spitz/Reed nevi are commonly small- to medium-sized, tan to black plaques, pASNT are large and nodular, either 'red' (dotted and/or polymorphous vascular pattern on dermoscopy; spindle and/or epithelioid tumors on histopathology: Spitz tumors, sensu strictiori) or 'blue' (homogeneous blue color on dermoscopy; intimate admixture of epithelioid cells and heavily pigmented dendritic cells on histopathology: Blitz tumors or pigmented epithelioid melanocytomas).
  • [MeSH-major] Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology


96. Rossiello L, Zalaudek I, Ferrara G, Docimo G, Giorgio CM, Argenziano G: Melanoacanthoma simulating pigmented spitz nevus: an unusual dermoscopy pitfall. Dermatol Surg; 2006 May;32(5):735-7
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  • [Title] Melanoacanthoma simulating pigmented spitz nevus: an unusual dermoscopy pitfall.
  • BACKGROUND: The starburst pattern is the dermoscopic hallmark of pigmented Spitz nevus, although it has been rarely observed in melanoma as well.
  • OBJECTIVE: To describe a case of melanoacanthoma simulating pigmented Spitz nevus.
  • MATERIAL AND METHODS: Clinical, dermoscopic, and histopathologic examinations were performed for the occurrence of a 4-mm pigmented skin lesion on the hip of a 38-year-old Caucasian woman.
  • RESULTS: Dermoscopy examination of the lesion disclosed a stereotypical starburst pattern characterized by pigmented streaks symmetrically distributed at the periphery.
  • A preoperative diagnosis of pigmented Spitz nevus was made, and the lesion was excised.
  • CONCLUSION: The starburst pattern, although diagnostic for pigmented Spitz nevus, can be rarely observed in other benign or malignant pigmented skin lesions.
  • [MeSH-major] Acanthoma / diagnosis. Dermoscopy. Nevus, Pigmented / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 16706772.001).
  • [ISSN] 1076-0512
  • [Journal-full-title] Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
  • [ISO-abbreviation] Dermatol Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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97. Berlingeri-Ramos AC, Morales-Burgos A, Sánchez JL, Nogales EM: Spitz nevus in a Hispanic population: a clinicopathological study of 130 cases. Am J Dermatopathol; 2010 May;32(3):267-75
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  • [Title] Spitz nevus in a Hispanic population: a clinicopathological study of 130 cases.
  • Spitz nevus is an uncommon melanocytic nevus distinctive by its epithelioid and spindled melanocytes.
  • Many studies have attempted to characterize Spitz nevus, but none of them in a Hispanic population.
  • Our aim is to characterize the clinical and histopathological presentation of the Spitz nevus in a Hispanic population.
  • A retrospective study was carried out from our files that included those cases histopathologically diagnosed as Spitz nevus.
  • The nevi followed a similar anatomic distribution in females and males.
  • The lesions were clinically diagnosed with accuracy in 20% of the cases and characterized as a pigmented papule in 42% of the cases.
  • Upon histopathological evaluation, most nevi exhibited symmetry (84%), were well circumscribed (91%), and exhibited epidermal hyperplasia (69%).
  • Sixty-eight percent of nevi were mostly composed of epithelioid melanocytes, the spindled-shaped melanocytes predominated in 17% of cases, and 12% were composed of both epithelioid and spindled-shaped melanocytes.
  • Multinucleated melanocytes were seen in 7% of nevi, mostly in the epithelioid Spitz nevus (67%).
  • Abundant melanin was observed in 51 cases, from which the most common variant was the classic Spitz nevi.
  • The typical dull eosinophilic globules (Kamino bodies) were observed in a minority of the cases (11%), mostly in the classic Spitz nevus.
  • The most common variant was the classic Spitz nevus (65%), followed by the dermal Spitz nevus (15%).
  • In conclusion, Spitz nevus in a Hispanic population most commonly presents as a pigmented papule on the lower extremities irrespective of sex and age.
  • It is characterized by a melanocytic proliferation most commonly composed of nested epithelioid melanocytes in a junctional or compound arrangement, with the presence of abundant melanin.
  • [MeSH-major] Hispanic Americans / ethnology. Nevus, Epithelioid and Spindle Cell / pathology. Skin Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Biomarkers, Tumor / metabolism. Child. Female. Humans. Male. Melanins / metabolism. Melanocytes / metabolism. Melanocytes / pathology. Puerto Rico / epidemiology. Reproducibility of Results. Retrospective Studies. Young Adult


98. Walters RF, Groben PA, Busam K, Millikan RC, Rabinovitz H, Cognetta A, Mihm MC Jr, Prieto VG, Googe PB, King R, Moore DT, Woosley J, Thomas NE: Consumption of the epidermis: a criterion in the differential diagnosis of melanoma and dysplastic nevi that is associated with increasing breslow depth and ulceration. Am J Dermatopathol; 2007 Dec;29(6):527-33
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  • [Title] Consumption of the epidermis: a criterion in the differential diagnosis of melanoma and dysplastic nevi that is associated with increasing breslow depth and ulceration.
  • Consumption of the epidermis (COE), defined as thinning of the epidermis with attenuation of basal and suprabasal layers and loss of rete ridges adjacent to collections of melanocytes, is a recently coined term encompassing changes of the epidermal architecture associated with melanoma.
  • To evaluate this feature as an additional diagnostic criterion for melanoma, we examined COE in 453 melanocytic lesions, including 213 invasive melanomas from a population-based series and 240 suspicious pigmented lesions from a clinic-based series, excluding halo and Spitz nevi.
  • In the population-based series, COE was identified in 92/213 (43%) invasive melanomas and became progressively more frequent with increasing Breslow depth (P < 0.0001) and Clark level (P = 0.0002).
  • COE was more frequent when mitotic figures (P < 0.0001), ulceration (P = 0.005), or vertical growth phase (P = 0.009) were present, but it was not significantly associated with age, gender, site, regression, or tumor-infiltrating lymphocytes.
  • In the clinic-based series of pigmented lesions, COE was present in 2/25 (8%) in situ melanomas, 1/29 (3%) lesions classified as melanoma in situ/high-grade dysplastic nevi, and 1/40 (2.5%) high-grade dysplastic nevi.
  • COE was not identified in 146 low-grade dysplastic, congenital, or common nevi.
  • In the combined datasets, 94/96 (98%) lesions exhibiting COE were classified as melanoma.
  • This study demonstrates that COE is frequently present in invasive melanomas, is associated with more aggressive histopathologic features (including increased Breslow depth and ulceration) and may be a useful supplementary diagnostic criterion for melanoma.

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  • (PMID = 18032946.001).
  • [ISSN] 1533-0311
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R03 CA103089; United States / NCI NIH HHS / CA / K07 CA102096-02; United States / NCI NIH HHS / CA / CA102096; United States / NCI NIH HHS / CA / K07 CA102096; United States / NCI NIH HHS / CA / CA112243; United States / NCI NIH HHS / CA / R01 CA112243; United States / NCI NIH HHS / CA / R01 CA112243-04; United States / NCI NIH HHS / CA / CA102096-02; United States / NCI NIH HHS / CA / CA112243-04
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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99. Nasr MR, El-Zammar O: Comparison of pHH3, Ki-67, and survivin immunoreactivity in benign and malignant melanocytic lesions. Am J Dermatopathol; 2008 Apr;30(2):117-22
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  • [Title] Comparison of pHH3, Ki-67, and survivin immunoreactivity in benign and malignant melanocytic lesions.
  • Differentiating malignant melanoma from benign melanocytic lesions can be challenging.
  • We undertook this study to evaluate the use of the immunohistochemical mitosis marker phospho-Histone H3 (pHH3) and the proliferation markers Ki-67 and survivin in separating malignant melanoma from benign nevi.
  • Sixty-six melanocytic lesions (18 malignant melanomas, 8 Spitz nevi, 20 dysplastic nevi, and 20 compound nevi) were stained with antibodies to pHH3, Ki-67, and survivin.
  • No pHH3 expression was detected in the dermis of compound and dysplastic nevi.
  • Rare mitoses were observed in the superficial dermis in 3 of 8 Spitz nevi (37%).
  • Staining for pHH3 was higher in malignant melanomas [average 25 per 10 high-power field (HPF), range 2-75 per 10 HPF] than in Spitz nevi (average 0.5 per 10 HPF, range 0-2 per 10 HPF) and was heterogeneously distributed in the malignant melanomas compared with a superficial dermal location in Spitz nevi.
  • There was no cytoplasmic staining for survivin in any of the 66 melanocytic lesions and no nuclear staining in any of the benign ones.
  • Survivin nuclear staining was present in 12 of 18 cases of malignant melanoma (67%) with an average index of 7% (range 0%-15%).
  • In benign melanocytic lesions, the Ki-67 index was less than 5% (range 0%-4%) and staining was present close to the dermo-epidermal junction compared with an average index of 27% in melanomas (range 5%-50%) and a generally heterogeneous pattern of staining throughout the dermis. pHH3 and Ki-67 can be useful adjuncts to histopathology to separate malignant melanoma from benign nevi. pHH3 is especially useful to highlight mitoses and to rapidly assess the mitotic activity in melanocytic lesions.
  • [MeSH-major] Biomarkers, Tumor / analysis. Histones / analysis. Ki-67 Antigen / analysis. Melanoma / chemistry. Microtubule-Associated Proteins / analysis. Neoplasm Proteins / analysis. Nevus, Epithelioid and Spindle Cell / chemistry. Nevus, Pigmented / chemistry. Skin Neoplasms / chemistry

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  • (PMID = 18360113.001).
  • [ISSN] 1533-0311
  • [Journal-full-title] The American Journal of dermatopathology
  • [ISO-abbreviation] Am J Dermatopathol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Biomarkers, Tumor; 0 / Histones; 0 / Inhibitor of Apoptosis Proteins; 0 / Ki-67 Antigen; 0 / Microtubule-Associated Proteins; 0 / Neoplasm Proteins
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100. Happle R: Speckled lentiginous naevus: which of the two disorders do you mean? Clin Exp Dermatol; 2009 Mar;34(2):133-5
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  • [Title] Speckled lentiginous naevus: which of the two disorders do you mean?
  • Speckled lentiginous naevus (synonym: naevus spilus) no longer represents one clinical entity, but rather, two different disorders can be distinguished.
  • Naevus spilus maculosus is consistently found in phacomatosis spilorosea, whereas naevus spilus papulosus represents a hallmark of phacomatosis pigmentokeratotica.
  • In contrast, naevus spilus papulosus is defined by dark papules that are of different sizes and rather unevenly distributed, reminiscent of a star map.
  • Histopathologically, the dark spots of naevus spilus maculosus show a 'jentigo' pattern and several nests of melanocytes involving the dermoepidermal junction at the tips of the papillae, whereas most of the dark speckles of naevus spilus papulosus are found to be dermal or compound melanocytic naevi.
  • The propensity to develop Spitz naevi appears to be the same in both types of speckled lentiginous naevus, whereas development of malignant melanoma has been reported far more commonly in naevus spilus maculosus.
  • [MeSH-major] Melanoma / pathology. Neurocutaneous Syndromes / pathology. Nevus, Pigmented / pathology. Skin Neoplasms / pathology

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  • [CommentOn] Clin Exp Dermatol. 2009 Mar;34(2):212-5 [19040514.001]
  • (PMID = 19040513.001).
  • [ISSN] 1365-2230
  • [Journal-full-title] Clinical and experimental dermatology
  • [ISO-abbreviation] Clin. Exp. Dermatol.
  • [Language] eng
  • [Publication-type] Comment; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 9
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