Skip to main content

Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis.

Publication ,  Journal Article
Kapur, P; Selim, MA; Roy, LC; Yegappan, M; Weinberg, AG; Hoang, MP
Published in: Mod Pathol
February 2005

A subset of Spitz nevi poses substantial diagnostic difficulty, even among experts, due to its resemblance to malignant melanoma. These lesions are termed atypical Spitz nevi/tumors and there is currently a lack of objective criteria for predicting their biologic behavior. We compared the expression of Ki-67, p21, and fatty acid synthase by immunohistochemistry in 10 atypical Spitz nevi, 28 typical Spitz nevi, 19 compound melanocytic nevi and 18 invasive malignant melanomas. There was a progressive increase in fatty acid synthase cytoplasmic expression with statistically significant differences observed between Spitz nevi and atypical Spitz nevi (P=0.003) and between atypical Spitz nevi and malignant melanoma (P<0.050). Ki-67 nuclear staining was lower in both typical and atypical forms of Spitz lesions than in malignant melanoma (P<0.001). The degree of P21 nuclear expression in atypical Spitz nevi was not significantly different than in Spitz nevi, but was significantly greater than expression in conventional nevi and approached significance after multiple comparisons corrections for malignant melanoma. Thus, a high level of P21 expression makes a tumor more likely to be a typical or atypical Spitz nevus than a malignant melanoma, especially when coupled with a low Ki-67 index and weak expression of fatty acid synthase. These immunohistochemical observations support the concept that atypical Spitz nevi are distinct lesions of borderline biologic behavior residing between Spitz nevi and malignant melanoma. The study also compared a large array of histologic features of 16 cases of typical Spitz nevi in children with 12 typical Spitz nevi in adults. The adult lesions were significantly more likely to be intradermal and to display dermal fibroplasia, but were histologically similar to their pediatric counterparts in all other respects.

Duke Scholars

Published In

Mod Pathol

DOI

ISSN

0893-3952

Publication Date

February 2005

Volume

18

Issue

2

Start / End Page

197 / 204

Location

United States

Related Subject Headings

  • Skin Neoplasms
  • Pathology
  • Nevus, Epithelioid and Spindle Cell
  • Nevus
  • Middle Aged
  • Melanoma
  • Male
  • Ki-67 Antigen
  • Infant
  • Immunohistochemistry
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kapur, P., Selim, M. A., Roy, L. C., Yegappan, M., Weinberg, A. G., & Hoang, M. P. (2005). Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis. Mod Pathol, 18(2), 197–204. https://doi.org/10.1038/modpathol.3800281
Kapur, Payal, M Angelica Selim, Lonnie C. Roy, Mani Yegappan, Arthur G. Weinberg, and Mai P. Hoang. “Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis.Mod Pathol 18, no. 2 (February 2005): 197–204. https://doi.org/10.1038/modpathol.3800281.
Kapur P, Selim MA, Roy LC, Yegappan M, Weinberg AG, Hoang MP. Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis. Mod Pathol. 2005 Feb;18(2):197–204.
Kapur, Payal, et al. “Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis.Mod Pathol, vol. 18, no. 2, Feb. 2005, pp. 197–204. Pubmed, doi:10.1038/modpathol.3800281.
Kapur P, Selim MA, Roy LC, Yegappan M, Weinberg AG, Hoang MP. Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis. Mod Pathol. 2005 Feb;18(2):197–204.

Published In

Mod Pathol

DOI

ISSN

0893-3952

Publication Date

February 2005

Volume

18

Issue

2

Start / End Page

197 / 204

Location

United States

Related Subject Headings

  • Skin Neoplasms
  • Pathology
  • Nevus, Epithelioid and Spindle Cell
  • Nevus
  • Middle Aged
  • Melanoma
  • Male
  • Ki-67 Antigen
  • Infant
  • Immunohistochemistry