c24t3P2: Is this a variant pattern in the setting of a “classic Spitz nevus?”

c24t3P3: Might the observer accept the patterns in this field as those of a combined nevus of common type (deep penetrating nevus pattern)? The degree of atypia in this field is worrisome. Inflammation is not a feature

c24t3P4a&b (case 7): Patterns are nevus-like. There are lentiginous and junctional patterns. The cells of the junctional nests are spindle shaped and dendritic in outline; they are variably pigmented. Centrally, near the dermal-epidermal interface, the papillary dermis is fibrotic and nests of tumor cells are loosely spaced. Sheets of “nevus-like” cells are present at the interface between the papillary dermis and the reticular dermis. The section is heavily stained with hematoxylin. In both fields, a dermal component is represented beneath the junctional nests.  In the area outlined by red arrows, there is a nodule of pale spindle cells; there is cytologic disparity, if the cells of the nodule are compared with the adjacent nevus-like cells. Inflammation is not a significant feature of the underlying reticular dermis. Is the nodule a vertical growth-like component?

c24t3P5: At higher magnification, the spindle cells of the nodule have pale, pink cytoplasm and elongated nuclei with irregular outlines. A cluster of nevus-like cells press upon the surface of the nodule. In the area of papillary dermal fibrosis, the nests of atypical cells are loosely but regularly spaced. Lamellar fibrosis is not a feature of this area. In this area, the degree of atypia in the nests is moderate to moderately severe.