Home Forums Melanoma: Newly Diagnosed – Stages I & II Spitz nevi and atypical Spitz nevi

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  • #22246
    antoit
    Participant

    Hello everyone,

    I have a question and i hope some of you has the knowledge to reply to this.

    4 weeks ago i got a mole removed from my back. It had appeared last year and was still quite small but was growing (it actually grew for few months then stabilised). I had it checked many times during the last months and 4 weeks ago i managed to “convince” the dermatologist to get it removed.

    I had it removed at the hospital as i couldn’t afford a private specialist.

    They never contacted me during the last 4 weeks and just gave me an appointment to discuss the results today. I kind of assumed that no news was good news!

    The dermatologist went very quickly through the results and read it in front of me on her screen…

    She probably thought i had no knowledge on this topic…

    She just told me everything was ok and the lesion was benign and that was it….that i could go home!

    While she was reading the report i caught the word ‘spitz” which reminded me of something suspicious…( as i am not new to the biopsy world)

    I asked her if there was anything wrong but she replied everything was fine.

    I don’t have the report with me yet ( which will be send to me in the next days) but now by looking online i found that spitz nevis are the ’tricky ones”.

    Why she didn’t mention that to me? is that because there is a difference in between spitz nevi and atypical spitz nevi? Are both considered border line or are just the atypical ones that are hard to read by pathologists as they look very similar to melanomas?

    I couldn’t find this information online so if anyone has any info about this would be appreciated!

    Needless to say that i am now thinking to get a second opinion! Although i still have to wait for a printed report and see what actually says!

    #65855
    Catherine Poole
    Keymaster

    A spitz nevus is benign and usually nothing to worry about. Some docs do go and take a wide excision, but for the most part this is not a worrisome lesion.

    #65856
    antoit
    Participant

    Hello Catherine, and thanks for your reply.

    Only today i got the printed results. It seems they exclude malignancy and don’t suggest any further investigation.

    If you have time to read the results you will find a sentence which states “…as the lesion starts to cut in only after 24 levels, further set of levels with immunisation will follow to definitely exclude malignancy….”

    What does it mean?

    Based on your experience do i have to make any further investigation on this?

    Thanks for your time.

    Specimen Type:

    A: LEFT SHOULDER

    Clinical Details:

    1 YEAR HISTORY OF NEW MOLE RIGHT SHOULDER. SLOWLY ENLARGING WITH BLURRED MARGIN. ADJACENT TO PREVIOUS BCC THEREFORE EXCESS SUN EXPOSURE IN PAST – EXCISE.

    Macroscopic Description:

    The specimen measures 0.5 x 0.4cm, with 1 lesion on the surface, measuring 0.1 x 0.1cm. All embedded, levels.

    Microscopic Description:

    Skin examined at 24 levels and shows a compound naevus with spitzoid features showing epithelioid and spindle features.

    The dermal comprises dyscohesive nests without any maturation. There are no mitoses or any evidence of pagetoid spread. Mild architectural disarray with lamellar fibrosis and fusion of rate are seen.

    Comments:

    Overall the features are benign. however as the lesion starts to cut in only after 24 levels, further set of levels with immunostains will follow to definitely exclude malignancy.

    Final diagnosis:

    COMPUND SPITZ NAEVUS, EXCISED {AWAIT IHC}

    ———————————————————————————————————————————————————————————————

    Amendments:

    10 further levels and immunostains for KI67 and HB45

    Interpretation:

    Further levels and immunostains for KI67 and HMB45 reveal mild architectural disarray with pigment only. There is no evidence of malignancy.

    #65857
    Catherine Poole
    Keymaster

    At the bottom of the report, it states: nterpretation:

    Further levels and immunostains for KI67 and HMB45 reveal mild architectural disarray with pigment only. There is no evidence of malignancy. So that mention was further staining of slides to detect malignancy and there was no evidence of it. So it is a benign nevus (spitzoid). Keep an eye on your skin though and celebrate too.

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