Jonjić Nives, Dekanić Andrea, Glavan Nedeljka, Prpić-Massari Larisa, Grahovac Blaženka
Department of Pathology, Rijeka University School of Medicine, Braće Branchetta 20, 51000 Rijeka, Croatia.
Department of Pediatric Surgery, Rijeka University Hospital Center, Rijeka, Croatia.
Case Rep Pathol. 2016;2016:8107671. doi: 10.1155/2016/8107671. Epub 2016 May 26.
A case of a 41-year-old woman with a history of nodular melanoma (NM), associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN); however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67) and molecular (BRAF V600E mutation) analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case.
本文报告一例41岁女性患者，有结节性黑色素瘤（NM）病史，其臀区有一个直径1.2厘米的硬结性圆顶状蓝黑色结节。该病变自出生就存在，临床诊断为蓝痣。最近，该结节有轻度增大，因此进行了完整切除。组织学分析显示，有一个色素沉着病变，呈向真皮和皮下脂肪组织浸润性生长模式。该病变表现为腺泡状模式以及色素性树突状细胞模式。组织学与细胞性蓝痣（CBN）相符；然而，一年前切除的NM病史以及该病变生长缓慢的临床信息，包括了对CBN、交界性黑素细胞肿瘤和恶性蓝痣的鉴别诊断。对两个病变，即类似CBN的病变和先前切除的NM，进行了额外的免疫组化（HMB-45、p16和Ki-67）及分子（BRAF V600E突变）分析。结合病变病史和组织学分析，p16染色和BRAF在本病例中是确认CBN良性性质的有用诊断工具。
