Nitta Y, Ohkochi Y, Hara K
Department of Dermatology, Aichi Medical University, Japan.
J Dermatol. 1995 Jul;22(7):500-3. doi: 10.1111/j.1346-8138.1995.tb03432.x.
Smith et al. (1989) have reported a variant of Spitz's nevus with histological atypical features. Despite local lymph node metastases, further metastases were not observed. They proposed the name "malignant Spitz nevus" for this variant. A 2-year-old Japanese girl had a large nodule (27 x 17 mm) surrounded by an indurated erythema over the Achilles tendon. Histologically, it proved to be a melanocytic lesion resembling spindle cell and epithelioid cell nevus (Spitz's nevus) with unusual features; the tumor extended deep into the subcutis, and the mitotic figures deep into the tumor, together with prominent lymphatic vessel invasion by melanocytes. Thus the tumor was aptly termed "malignant Spitz nevus". Flow cytometric analysis of the DNA content revealed a diploid pattern. The child is well 5 years after a wide resection of the tumor. The diploid pattern of the DNA content as well as the good prognosis could support the idea that "malignant Spitz nevus" fits within the spectrum of Spitz's nevus.
史密斯等人（1989年）报告了一种具有组织学非典型特征的斯皮茨痣变体。尽管出现了局部淋巴结转移，但未观察到进一步的转移。他们为此变体提出了“恶性斯皮茨痣”这一名称。一名2岁日本女孩在跟腱处有一个大结节（27×17毫米），周围有硬结性红斑。组织学检查显示，这是一个黑素细胞病变，类似于具有异常特征的梭形细胞和上皮样细胞痣（斯皮茨痣）；肿瘤深入皮下组织，肿瘤深部有核分裂象，同时黑素细胞有明显的淋巴管浸润。因此，该肿瘤被恰当地称为“恶性斯皮茨痣”。DNA含量的流式细胞术分析显示为二倍体模式。该患儿在肿瘤广泛切除5年后情况良好。DNA含量的二倍体模式以及良好的预后支持了“恶性斯皮茨痣”属于斯皮茨痣谱系这一观点。
