Pathology, Johns Hopkins University, Baltimore, Maryland, USA
Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
J Clin Pathol. 2021 Mar;74(3):167-170. doi: 10.1136/jclinpath-2020-206757. Epub 2020 Jul 6.
Blue nevus (BN) is a benign melanocytic proliferation that is typically cutaneous. Extracutaneous BN is infrequent and is reported in the mucosa of various organs. Gastrointestinal (GI) tract BN is rare. Here, we describe the clinicopathological findings of the largest series of GI tract BNs.
A search of our Pathology Data System (1984-2019) identified six GI tract blue nevi. Clinical information, pathology reports and available H&E-stained section slides were reviewed.
Lesions predominated in the middle-aged adults (mean 54, range 27-80) with a slight female predominance (66%). Most cases arose in the rectum and colon (83%), with one gastric lesion (17%). Four cases were identified during endoscopic examination performed either for screening or for unrelated symptoms (66%). Two patients presented with rectal bleeding (33%) unassociated with the BN. Endoscopically, most lesions appeared as superficial hyperpigmented areas (83%). One case was described as abnormal mucosa (17%). Microscopically, the mucosa was involved in all of the cases (100%). One case showed submucosal extension in addition to the mucosal component (17%). Lesions showed a proliferation of bland spindle cells with abundant granular pigment. No nuclear atypia or mitoses were identified. Immunostains showed immunoreactivity for melanocytic markers. Follow-up information available for five patients showed no recurrences to date (mean follow-up 1 year).
BN is a benign melanocytic proliferation. It is important to be aware of the occurrence of such lesions outside of the skin and consider the possibility of BN when pigmented lesions are encountered in the GI tract.
蓝色痣（BN）是一种良性黑色素细胞增生，通常发生在皮肤。皮肤外的 BN 很少见，据报道发生在各种器官的粘膜中。胃肠道（GI）道 BN 罕见。在此，我们描述了最大系列的胃肠道 BN 的临床病理发现。
通过对我们的病理数据系统（1984-2019 年）进行检索，共确定了 6 例胃肠道蓝色痣。回顾了临床信息、病理报告和可用的 H&E 染色切片。
病变主要发生在中年人（平均年龄 54 岁，范围 27-80 岁），女性略多（66%）。大多数病例发生在直肠和结肠（83%），胃病变 1 例（17%）。4 例是在进行筛查或与 BN 无关的症状的内镜检查中发现的（66%）。2 例患者出现直肠出血（33%），与 BN 无关。内镜下，大多数病变表现为浅表色素沉着区（83%）。1 例描述为异常粘膜（17%）。显微镜下，所有病例均累及粘膜（100%）。1 例除粘膜成分外还有粘膜下延伸（17%）。病变表现为大量颗粒状色素的温和梭形细胞增生。未见核异型性或有丝分裂。免疫组化显示黑色素细胞标志物的免疫反应性。5 例患者的随访信息显示目前无复发（平均随访 1 年）。
BN 是一种良性黑色素细胞增生。当在胃肠道遇到色素沉着病变时，重要的是要意识到这种病变在皮肤以外的发生，并考虑到 BN 的可能性。
