Helm Matthew F, Bax Michael J, Bogner Paul N, Chung Catherine G
Department of Dermatology, Penn State Health Hershey Medical Center, Hershey, Pennsylvania.
Department of Dermatology, Roswell Park Cancer Institute, Buffalo, New York.
JAAD Case Rep. 2017 Mar 15;3(2):135-137. doi: 10.1016/j.jdcr.2017.01.019. eCollection 2017 Mar.
Metastatic melanoma may exhibit clinical or histologic features of blue nevus. Pembrolizumab therapy is associated with regression and tumoral melanosis. We report on a man with widespread metastatic melanoma on pembrolizumab therapy in whom a blue-grey papule developed on the left side of his neck that clinically resembled a blue nevus and histologically showed features of both blue nevus and tumoral melanosis. The subtle melanocytic component and prominent changes of regression evident on biopsy suggest that his immunomodulatory therapy may have influenced the histologic findings noted on biopsy. Physicians that treat patients with metastatic melanoma should be aware of the spectrum of histologic findings evident on biopsy not only to allow for early diagnosis but to also better understand the effects of treatment.
转移性黑色素瘤可能表现出蓝痣的临床或组织学特征。帕博利珠单抗治疗与肿瘤消退和肿瘤性黑素沉着有关。我们报告了一名接受帕博利珠单抗治疗的广泛转移性黑色素瘤男性患者，其颈部左侧出现了一个蓝灰色丘疹，临床上类似于蓝痣，组织学检查显示具有蓝痣和肿瘤性黑素沉着的特征。活检时明显的细微黑素细胞成分和显著的消退变化表明，他的免疫调节治疗可能影响了活检时所观察到的组织学结果。治疗转移性黑色素瘤患者的医生应了解活检时明显的组织学表现范围，不仅以便早期诊断，而且更好地理解治疗效果。
