Rady Children's Hospital San Diego and the University of California, San Diego, California 92123, USA.
J Am Acad Dermatol. 2011 Mar;64(3):559-72. doi: 10.1016/j.jaad.2009.12.063. Epub 2011 Jan 20.
Spitz nevi represent a distinct type of melanocytic nevi more commonly seen in childhood. Although typically benign, a subset of Spitz lesions raise concern and create a diagnostic dilemma as a result of confusing histology that involves characteristics of classic Spitz nevi intermixed with features of cutaneous melanoma. Such atypical Spitz lesions, or Spitzoid tumors of uncertain malignant potential, are difficult to classify and their biologic potential is uncertain. Nonetheless, these are critical tasks for both prognosis and clinical management. New tools, such as immunohistochemical stains, comparative genomic hybridization, and fluorescence in situ hybridization, have been used to provide further insight into these controversial lesions and to aid in their evaluation. In this review, we present our experience managing 6 cases of Spitzoid tumor of uncertain malignant potential and discuss the potential use of various diagnostic modalities, including sentinel lymph node biopsy, immunostaining, and molecular analysis.
Spitz 痣是一种独特的黑色素痣类型，更常见于儿童期。尽管通常是良性的，但 Spitz 病变的一部分由于涉及经典 Spitz 痣与皮肤黑色素瘤特征混合的混淆组织学而引起关注，并造成诊断上的困境。这些非典型 Spitz 病变或不确定恶性潜能的 Spitz 样肿瘤难以分类，其生物学潜能不确定。尽管如此，这些对于预后和临床管理都是至关重要的任务。新的工具，如免疫组织化学染色、比较基因组杂交和荧光原位杂交，已被用于更深入地了解这些有争议的病变，并帮助评估它们。在这篇综述中，我们介绍了我们管理 6 例不确定恶性潜能的 Spitz 样肿瘤的经验，并讨论了各种诊断方式的潜在用途，包括前哨淋巴结活检、免疫染色和分子分析。
