Pulitzer D R, Martin P C, Cohen A P, Reed R J
Department of Pathology, Tulane University School of Medicine, New Orleans, Louisiana 70112.
Am J Surg Pathol. 1991 Dec;15(12):1111-22. doi: 10.1097/00000478-199112000-00001.
The designation combined nevus gives recognition to mixed cytologic patterns. In the common variant, plump, pigmented spindle cells form fascicles among nests of ordinary nevus cells. In other variants, one or several cellular components that share cytologic features with either a blue nevus or a Spitz nevus are represented. Ninety-five cases, 49% of which were of the common type, were studied. Grossly, most of the lesions were darkly pigmented papules or nodules. The clinical diagnosis in three-fourths of the cases was nevus, blue nevus, or melanoma. Fifteen percent had concomitant histologic features of melanocytic dysplasia, and most of these lesions were of the common type. For the common variant, the cytologic features, pattern of apparent infiltration, and variable representation of the features of a premalignant melanocytic dysplasia often mislead a pathologist in interpreting and predicting biologic potential. In combined nevi, the phenotypic diversity and genetic lability of melanocytic nevus cells is manifested.
复合痣这一命名认可了混合的细胞学模式。在常见类型中，丰满的、色素沉着的梭形细胞在普通痣细胞巢之间形成束状结构。在其他类型中，存在一种或几种与蓝痣或Spitz痣具有共同细胞学特征的细胞成分。对95例病例进行了研究，其中49%为常见类型。大体上，大多数病变为深色色素沉着的丘疹或结节。四分之三病例的临床诊断为痣、蓝痣或黑色素瘤。15%伴有黑素细胞发育异常的组织学特征，且这些病变大多为常见类型。对于常见类型，细胞学特征、明显浸润模式以及恶性前期黑素细胞发育异常特征的不同表现，常常使病理学家在解释和预测生物学潜能时产生误导。在复合痣中，黑素细胞痣细胞的表型多样性和遗传不稳定性得以体现。
