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A diagnosis is confirmed when an individual has at least two of the following: a family history of Nf1 a glioma, or tumor, on the optic nerve, usually without symptoms lesions in the bone at least six “café-au-lait” spots measuring more than 5 millimeters across in children or 15 millimeters in adolescents and adults at least two Lisch nodules, or small brown spots in the iris freckling in the armpits, under the breast, or in the groin area two or more neurofibromas, or one “plexiform” Plexiforms affect around 25 percent of people with Nf1