Department of Pathology and Laboratory Medicine, Summa Health System, Akron City, OH; and.
Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH.
Am J Dermatopathol. 2021 May 1;43(5):e61-e64. doi: 10.1097/DAD.0000000000001913.
Histologic distinction between melanoma ex-blue nevus and cellular blue nevus (CBN) can often be difficult, but features supporting melanoma include infiltrative growth pattern, frequent mitoses, cytologic atypia and pleomorphism, cell crowding, and tumor necrosis. Unfortunately, these features are not constantly dependable and frequently borderline lesions exist, so-called atypical CBN, which lack explicit malignant features. Furthermore, some CBN and atypical CBN show an assortment of features, which may lead to their misdiagnosis as melanoma, but to date necrosis is generally absent. We present an unusual case of an atypical cellular blue nevus with extensive necrosis mimicking melanoma ex-blue nevus.
黑素细胞痣源于蓝痣与细胞性蓝痣之间的组织学鉴别往往较为困难，但支持黑素瘤的特征包括浸润性生长模式、频繁的有丝分裂、细胞学异型性和多形性、细胞拥挤和肿瘤坏死。不幸的是，这些特征并非始终可靠，并且经常存在边界病变，即所谓的非典型性细胞性蓝痣，其缺乏明确的恶性特征。此外，一些细胞性蓝痣和非典型性细胞性蓝痣表现出多种特征，这可能导致误诊为黑色素瘤，但迄今为止通常不存在坏死。我们提出了一个不典型的细胞性蓝痣的罕见病例，其广泛坏死类似于源于蓝痣的黑色素瘤。
