obsolete epithelioid and spindle cell nevus

Obsolete Epithelioid and Spindle Cell Nevus

The term "obsolete epithelioid and spindle cell nevus" refers to a type of skin lesion that was previously considered a distinct entity, but is now no longer recognized as a separate condition. This term was used in the past to describe a benign melanocytic neoplasm characterized by the presence of epithelioid and spindle-shaped cells.

Characteristics

According to medical literature [1], this type of skin lesion was typically smooth, hairless, and light to dark brown in color, with a slightly elevated appearance. It could occur as a single lesion or multiple lesions on any part of the body.

Relationship to Other Conditions

The obsolete epithelioid and spindle cell nevus is no longer considered a separate condition due to its overlapping features with other types of melanocytic nevi, such as Spitz nevi [2]. In fact, some sources consider it to be synonymous with Spitz nevi [3].

Current Understanding

Today, the term "obsolete epithelioid and spindle cell nevus" is no longer used in medical literature. Instead, conditions like Spitz nevi are recognized as benign melanocytic neoplasms that can occur in children and adults alike [4]. These lesions are characterized by their symmetrical and well-demarcated appearance, with a wedge-shaped growth pattern and the presence of large melanocytic nests composed entirely of spindle and epithelioid cells [5].

References

[1] Context result 4 [2] Context result 12 [3] Context result 14 [4] Context result 9 [5] Context result 11

Diagnostic Tests for Epithelioid and Spindle Cell Nevus

Epithelioid and spindle cell nevus, also known as Spitz nevus, is a benign melanocytic tumor that can be challenging to diagnose due to its similarity in appearance to malignant melanoma. To confirm the diagnosis of epithelioid and spindle cell nevus, several diagnostic tests can be performed.

• Histopathological examination: A biopsy sample from the lesion is examined under a microscope by a dermatopathologist. The histological features of epithelioid and spindle cell nevus include symmetrical and well-demarcated tumor with epidermal hyperplasia, hypergranulosis, and hyperkeratosis. The tumor consists of large melanocytic nests composed entirely of spindle and epithelioid cells containing abundant cytoplasm with varying amounts of melanin granules [6].
• Immunohistochemistry: This test can help differentiate epithelioid and spindle cell nevus from malignant melanoma by identifying specific markers such as HMB-45, Melan-A, and S100 protein.
• Molecular testing: Advanced molecular diagnostic techniques may be used to confirm the diagnosis of epithelioid and spindle cell nevus. These tests can identify genetic mutations that are characteristic of this condition [12].
• Clinical evaluation: A thorough clinical evaluation by a dermatologist or a specialist in dermatopathology is essential to rule out other conditions that may mimic epithelioid and spindle cell nevus.

It's worth noting that the diagnosis and management of patients with Spitz nevi can be difficult, above all because most cases of atypical Spitz nevi cannot be differentiated from melanoma [8]. Therefore, a consultation with a specialty dermatopathologist can be very helpful in making an accurate diagnosis.

References: [6] - The tumor consists of large melanocytic nests composed entirely of spindle and epithelioid cells containing abundant cytoplasm with varying amounts of melanin granules. [12] - Consultation with a specialty dermatopathologist can be very helpful, and advanced molecular diagnostic techniques may be used in selected circumstances.

The differential diagnosis for an obsolete epithelioid and spindle cell nevus, also known as Spitz nevus or spindle and epithelioid cell nevus, is a crucial aspect in dermatopathology. According to various medical sources [1][2][3], the following entities should be considered in the differential diagnosis:

• Spindled melanoma: A form of cutaneous melanoma that can mimic the appearance of Spitz nevus.
• Nevoid melanoma: A rare type of malignant melanoma that can present with features similar to those of spindle and epithelioid cell nevus [4].
• Verrucous dermal nevus: A benign skin lesion that can be confused with Spitz nevus due to its similar histological appearance.
• Melanocytic nevi: Other types of melanocytic lesions, such as common acquired melanocytic nevi (CAMNs), should also be considered in the differential diagnosis [5].
• Neurofibroma and schwannoma: These are benign nerve sheath tumors that can present with features similar to those of Spitz nevus.
• Melanocytic lesions with atypical features: Such as atypical Spitz tumor or melanoma, should also be considered in the differential diagnosis [6].

It's worth noting that the differential diagnosis for Spitz nevus is extensive and requires a thorough examination of the histopathological features, clinical presentation, and molecular analysis to arrive at an accurate diagnosis.

References:

[1] Tahir, M. (2024). The differential diagnosis of MCNH includes various benign and malignant entities... [Source 7]

[2] Wick, MR. (2016). As cutaneous melanomas manifest a wide spectrum of clinical and pathologic presentations... [Source 5]

[3] Gigliotti, MJ. (2021). Using immunohistochemistry and molecular analysis, a definite pathological diagnosis is possible for many forms of malignant spindle cell tumor. [Source 9]

[4] Nevoid melanoma: A clinicopathological study of seven cases of malignant melanoma mimicking spindle and epithelioid cell nevus and verrucous dermal nevus. Hum Pathol. 1995; 26:171-179. [Source 13]

[5] Any form of melanocytic nevus may occur as a congenital tumor, demonstrating a tendency to grow into or along dermal appendages or neurovascular structures. [Source 3]

[6] Spitz nevus, also known as Spitz tumor or spindle and epithelioid cell nevus, is an usually acquired, benign melanocytic lesion... [Source 14]