Liu Jing, Cohen Philip R, Farhood Anwar
Department of Pathology, The University of Texas-Houston Medical School, University of Houston Health Center, Houston, TX, USA.
South Med J. 2004 Jan;97(1):102-6. doi: 10.1097/01.SMJ.0000055103.97445.AB.
Hyalinizing spindle and epithelioid cell nevus (Spitz nevus) is an uncommon melanocytic lesion. The histologic features of this benign tumor can mimic those of certain benign (dermatofibroma and desmoplastic cellular blue nevus) and malignant (metastatic carcinoma and malignant melanoma) neoplasms. We report a woman with a hyalinizing Spitz nevus and review the clinical characteristics, histologic features, and differential diagnosis of this lesion. The lesion presented as an asymptomatic red firm nodule on her abdomen. Microscopic examination showed a symmetric lesion in the dermis. The neoplastic cells were large and epithelioid-shaped or plump and spindle-shaped. They were present as isolated individual cells, single cells in a linear pattern, small nests, and fascicles in a paucicellular hyalinized stroma. Neoplastic cells with prominent eosinophilic nucleoli were evenly exhibited from the superficial to deep lesion. Diffuse expression of S-100 protein and absence of staining with antibodies to cytokeratin and HMB-45 were observed. The features were diagnostic of a hyalinizing Spitz nevus. Hyalinizing Spitz nevus is a benign lesion whose histologic features may mimic dermatofibroma, desmoplastic cellular blue nevus, metastatic carcinoma, and malignant melanoma. Immunohistochemical studies are helpful to differentiate these lesions.
透明变性梭形及上皮样细胞痣（斯皮茨痣）是一种罕见的黑素细胞性病变。这种良性肿瘤的组织学特征可与某些良性（皮肤纤维瘤和促纤维增生性细胞蓝色痣）及恶性（转移性癌和恶性黑色素瘤）肿瘤相似。我们报告一名患有透明变性斯皮茨痣的女性，并回顾该病变的临床特征、组织学特征及鉴别诊断。该病变表现为她腹部一个无症状的红色坚实结节。显微镜检查显示真皮内有一个对称病变。肿瘤细胞大，呈上皮样或丰满的梭形。它们以单个孤立细胞、线性排列的单个细胞、小巢状以及在少细胞透明变性基质中的束状形式存在。从病变浅表至深部均可见有突出嗜酸性核仁的肿瘤细胞均匀分布。观察到S - 100蛋白弥漫性表达，细胞角蛋白抗体和HMB - 45染色阴性。这些特征可诊断为透明变性斯皮茨痣。透明变性斯皮茨痣是一种良性病变，其组织学特征可能与皮肤纤维瘤、促纤维增生性细胞蓝色痣、转移性癌和恶性黑色素瘤相似。免疫组织化学研究有助于鉴别这些病变。
