Melanoma with Spindle Cell

The spindle cell melanoma is not really a type of melanoma. Fusiform melanocytes with elongated nuclei can be seen in all of the forms of invasive melanoma. The spindle cells usually lie in compact fascicles but can be seen between thickened collagen bundles (desmoplastic melanoma, see Chap. 36) or form individual fascicles, simulating a neural neoplasm. Perineural invasion is a fi nding that occurs much more frequently in melanomas with spindled cells. Melanomas in which spindle cells predominate have been termed “pseudosarcomatous.” Indeed, early twentieth-century pathologists discriminated between “melanocarcinoma” and “melanosarcoma.”