Pigmented Spindle Cell Melanocytic Tumor

The pigmented spindle cell tumor (PSCT) is considered by some to be a pigmented variant of Spitz tumor, and it is clear that clinical and histological overlap occurs between the two lesions. However, the PSCT may show rather distinctive attributes in a large proportion of cases. The lesion usually presents as a small well-defined dark brown to black flat topped papule (Fig. 11A). Histologically, PSCT is a sharply circumscribed mainly intraepidermal proliferation of small heavily pigmen-ted spindle-shaped melanocytes arranged in fascicles or concentric arrays (Figs. 11B-D). A conspicuous feature of PSCT causing considerable confusion with melanoma is pagetoid melanocytosis (Table 16).

Synonyms: Pigmented spindle cell nevus of reed; pigmented spindle cell tumor.

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