Wang Lei, Wang Gang, Gao Tianwen
Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xian, China.
J Cutan Pathol. 2013 May;40(5):497-502. doi: 10.1111/cup.12076. Epub 2013 Mar 11.
Neural differentiation by melanocytic nevi represents a well-recognized phenomenon, and melanocytic nevi with perineurial differentiation have been reported recently. We reported a case of a congenital melanocytic nevus with histopathologic features of hybrid schwannoma/perineurioma. The patient was a 36-year-old male who presented with a black tumor on his arm since birth. Histopathology showed a congenital melanocytic nevus in the superficial dermis, but more strikingly, in continuity with the melanocytic nevus, there was a well-circumscribed but unencapsulated nodule in the deep dermis. The nodule was composed of cellular and myxoid areas with storiform, laminated or whorled growth patterns. The cellular area was mainly composed of proliferation of plump spindle, oval or epithelioid cells. The myxoid area was mainly composed of proliferation of slender spindle cells with mucin deposition. Immunohistochemical stains showed that the cellular area was positive for S100 and CD34, weakly positive for EMA, negative for Glut-1 and collagen IV, the myxoid area was positive for S100, negative for CD34, strongly positive for EMA and focally positive for Glut-1 and collagen IV. Our results show that congenital melanocytic nevi may show neural differentiation with histopathologic features of hybrid schwannoma/perineurioma.
黑素细胞痣的神经分化是一种公认的现象，并且最近有关于具有神经束膜分化的黑素细胞痣的报道。我们报告了一例具有混合性神经鞘瘤/神经束膜瘤组织病理学特征的先天性黑素细胞痣。患者为一名36岁男性，自出生以来手臂上就有一个黑色肿物。组织病理学显示，在浅表真皮层有一个先天性黑素细胞痣，但更显著的是，与黑素细胞痣相连，在深部真皮层有一个边界清楚但无包膜的结节。该结节由细胞区和黏液样区组成，呈束状、层状或漩涡状生长模式。细胞区主要由丰满的梭形、椭圆形或上皮样细胞增殖构成。黏液样区主要由细长的梭形细胞增殖并伴有黏液沉积构成。免疫组织化学染色显示，细胞区S100和CD34阳性，EMA弱阳性，Glut-1和IV型胶原阴性；黏液样区S100阳性，CD34阴性，EMA强阳性，Glut-1和IV型胶原局灶性阳性。我们的结果表明，先天性黑素细胞痣可能表现出具有混合性神经鞘瘤/神经束膜瘤组织病理学特征的神经分化。
