Misago Noriyuki, Nagase Kohtarou, Toda Shuji, Shinoda Yohsuke, Koba Shinich, Narisawa Yutaka
Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Eur J Dermatol. 2008 Sep-Oct;18(5):586-9. doi: 10.1684/ejd.2008.0493. Epub 2008 Aug 8.
Regional lymph node involvement by a cellular blue nevus has been reported. However, it has recently been suggested that specific cases with "benign metastasizing" cellular blue nevi are actually rare. This study describes a typical case of a cellular blue nevus with nevus cells in a sentinel lymph node. We demonstrated that a cellular blue nevus clearly involved the regional lymph node and investigated the immunohistochemical profiles of such nodal cellular blue nevus cells. The location of the nevus cells fundamentally indicated a benign type, with limitation to the capsule and the fibrous trabeculae. However, only a few, isolated nevus cells were also seen in the parenchyma of the lymph node. The nevus cells in the capsule and the fibrous trabeculae were positive for c-kit, like the migrating melanocytes from the neural crest. In cellular blue nevi or lesions with similar histopathological features, it may be appropriate to consider the predominant involvement of the capsule as well as the benign cytological features and the immunohistochemical profiles (Ki-67-, PCNA-, and c-kit+) of the nodal cells to be a benign sign.
已有报道细胞性蓝痣累及区域淋巴结。然而，最近有人提出，具有“良性转移”的细胞性蓝痣的特定病例实际上很罕见。本研究描述了一例典型的细胞性蓝痣病例，其前哨淋巴结中存在痣细胞。我们证实细胞性蓝痣明显累及区域淋巴结，并研究了此类淋巴结内细胞性蓝痣细胞的免疫组化特征。痣细胞的位置基本表明为良性类型，局限于被膜和纤维小梁。然而，在淋巴结实质中也仅可见少数孤立的痣细胞。被膜和纤维小梁中的痣细胞c-kit呈阳性，类似于来自神经嵴的迁移黑素细胞。在细胞性蓝痣或具有相似组织病理学特征的病变中，考虑到主要累及被膜以及淋巴结细胞的良性细胞学特征和免疫组化特征（Ki-67、PCNA和c-kit阳性），可能提示为良性表现。
