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Sophie Spitz (1910 1956) Prepared by: Dr P Curnow, 2000

 

Claim to Fame: Spitz Naevus

Spitz naevus (also known as spindle and epithelioid cell naevus or juvenile melanoma) is a benign melanocytic compound naevus variant which is seen most commonly in children and which has distinctive histological features.

An uncommon lesion, accounting for less than 1% of all melanocytic naevi in children, it is usually seen in the first two decades of life, becoming rarer with age. It presents as a firm, rounded, red or reddish brown nodule which grows rapidly over a six month period to a size up to 1-2 cm. It has a smooth surface but can bleed or crust after injury. The commonest sites are the face, particularly the cheeks, and the legs.

Excision with a narrow margin is required to confirm the diagnosis and to exclude malignant melanoma, although melanoma is rare in childhood.

The histological features of Spitz naevi include plump spindle shaped or less often epithelioid cells arranged as a symmetrical naevus with maturation of cells in deeper areas. They lack pagetoid spread of melanocytes into the epidermis and have a distinctive feature called Kamino bodies which are eosinophilic globules at the dermoepidermal junction. Melanin is rarely plentiful and may be absent.

Paper:

Spitz S. Melanomas of childhood. Am J Pathol 1948; 24:591-609.

Background:

Born in Nashville, Tennessee, in 1910 to Jewish immigrants from Germany, she was a keen student from a young age and was exposed to pathology in her teens by her uncle, Herman Spitz, a clinical pathologist in the early days of the specialty. She went on to graduate from the Vanderbilt University School of Medicine in 1932 and did her residency at the New York Infirmary for Women and Children.

She wished to pursue a surgical career but her gender at that time barred this course, so she instead entered training in the field of pathology. During this period she was strongly influenced by pathologist Elise Strang L'Esperance and worked in the philanthropic cancer prevention clinics that she had established. Her strong perspective and determination was demonstrated by her advocacy of the newly devised pap smear, a new test initially rejected by the medical community, because she had the foresight to see its value in preventing cervical cancer.

In 1942, on a blind date, she met Arthur Allen who was himself a pathologist, and they married later that year. Around this time her career course was altered by her enrolment in the Army Institute of Pathology where she served as a pathologist until 1945. During this period she developed an interest in tropical diseases and co-authored an atlas of pathology on this subject, while also writing papers on malaria and rickettsial diseases and revising an orthopaedic pathology atlas.

After the war she continued to work at the New York Infirmary and joined the team at the Memorial Sloan-Kettering Cancer Hospital. It was here that she collected the series of 12 cases of childhood melanoma that she described in the American Journal of Pathology in 1948 and which now bear her name. Her other achievements included a paper discussing the carcinogenic potential of benzidine used in the dye industry, and collaborations with her husband on several published works on melanoma. She is recognised as one of the great pathologists of her time but developed bowel cancer and died at age 46, without ever hearing the term Spitz naevus.

References:

Shapiro, PE. Who Was Sophie Spitz? Am J Dermatopath. v14 (5): pp442-446, 1992.

Weedon D. Skin Pathology. Churchill Livinstone. 1997 p681.

Rook et al. Textbook of Dermatology. Blackwell Science Vol 2 6th ed pp1726-27, 1998.