悪性黒色腫との鑑別に苦慮した足底Spitz母斑の1例

概要

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A 15-year-old boy developed a gray-black macule on his right sole. Its size was 12×5mm and there was a verrucous point at the center of the lesion when he first visited our hospital. Moreover, the lesion showed slight color-and border-irregularity. Histopathologically, the lesion is almost symmetrical in shape and well demarcated. The tumor cells are almost epitheloid with large nuclei and larger in size than ordinary nevus cells. The tumor cell nests exist in the epidermal-dermal junction through the lower dermis. Maturation of cells is poorly recognized. However, some eosinophilic globules are recognized and there is little inflammatory-cell-infiltration around the nests. Immunohistochemically. HMB-45 antibody demonstrates positive especially at deeper nests and S-100 protein strongly demonstrates positive. Fluorescence microscopy of an unstained specimen demonstrates almost negative. The tissue level of 5-S-cysteinyldopa was 77.1ng/mg. Cellular DNA content is 2.68C which is higher than that of Spitz nevus reported before. The number of aneuploid cells are more than that in usual Spitz nevus reported before. The number of aneuploid cells are more than that in usual Spitz nevus. However, from the histopathological findings especially its symmetrical shape, we diagnosed this lesion as Spitz nevus, although it is important to continue careful follow-up study for this case.