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c12t3P1: This is a compound spindle cell melanocytic dysplasia; there are ill-defined Spitz nevus-like qualities, particularly in regard to cytologic features. The cells are plump and have enlarged, hyperchromatic nuclei. There are scattered giant cells. There are occasional, randomly spaced nests of atypical cells in the fibrotic papillary dermis. This lesion might be characterized as an atypical spindle cell melanocytoma, and additionally qualified as borderline melanocytic neoplasia of indeterminate malignant potential. It would measure less than 1 mm in vertical dimensions; this limited physical attribute would qualify this atypical lesion as borderline. Some of the atypical cells have migrated upward.
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c12t3P2: Spitz nevus-like features, albeit atypical, are combined with features of a premalignant melanocytic dysplasia; this combination qualifies as atypical spindle cell melanocytoma of Spitz nevus-like type. In this definition of atypical spindle cell melanocytoma of Spitz-like type, there is a physical restriction that is lacking in Barnhill’s “atypical Spitz nevu/tumor.”
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c12t3P3: The dermal component of halo nevus commonly shows atypia. Some, or many, of the cells of the dermal component are enlarged and rounded (epithelioid). The enlarged cells show variation in nuclear size; the enlarged nuclei are round and densely chromatic. The patterns of a common nevus with loosely spaced nests and fascicles of cells are preserved. The lymphoid infiltrates are of halo nevus type.
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c12t3P4: In some halo nevi, the atypical cells are prominently epithelioid. Some of the enlarged nuclei are hyperchromatic with a central nucleolus; some have open chromatin patterns with a central nucleolus. The cells, both large and small, form loosely spaced nests; many are individually isolated in the widened papillary dermis. The lymphoid infiltrates provide a halo nevus-like quality. The patterns are not those of a typical vertical growth component. The patterns are those of an atypical halo nevus with dysplasia of dermal type.
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c12t3P5: Atypical halo nevus with dysplasia of dermal type. This is not a “Spitz nevus” with halo nevus phenomena.
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c12t3P6: The peripheral “halo” of an uncomplicated halo nevus is represented. There is epidermal hypomelanosis. Focally, lymphoid cells have migrated into the epidermis to produce a mild lichenoid reaction.
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c12t3P7: With a Fontana-Masson (silver stain), the depigmented halo is represented on the right. The normal pigmentation of the basal layer of the epidermis is seen on the left.
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