Zhao Ying, Shi Wangpan, Tie Yateng, Li Xiaorong, Wang Huifang, Ren Dong, Cai Fengmei
Center for Pathology Diagnosis, Xi 'an People's Hospital (Xi 'an Fourth Hospital), Xi 'an, Shaanxi, China.
Department of Pathology, University of California San Diego Health System, San Diego, CA.
Am J Dermatopathol. 2025 Apr 1;47(4):287-291. doi: 10.1097/DAD.0000000000002921. Epub 2025 Jan 23.
Limited studies have been conducted on juvenile conjunctival nevus (JCN) in Asian populations. This study aims to investigate the clinical and pathologic characteristics of JCN cases among the Han ethnicity in northwest China, providing insights for pathologists and ophthalmologists in diagnosing this condition.
A subset of conjunctival nevi in children and adolescents, characterized by a confluent growth pattern and lack of maturation, was identified and defined as JCN. A retrospective analysis of the clinicopathologic features of these cases was performed.
The study included 40 patients aged 3-20 years, with a median age of 15.5 years. Six cases involved congenital conjunctival pigmentation. Twenty-four were male patients and 16 were female patients, with a male-to-female ratio of 1.5:1. Microscopically, nevus cells grew confluently within or beneath the epidermis and exhibited moderate cellular atypia. In some cases, the junction of the epithelium and the lamina propria layer was obscured by the integration of nevus cell clusters, mimicking epithelial invasion and potentially leading to a misdiagnosis. Over an average follow-up of 78.5 months, no recurrence or postoperative complications were observed.
Diagnosing JCN is challenging because of its histologic resemblance to conjunctival melanoma. A systematic analysis of JCN can improve the recognition of its benign nature by pathologists and ophthalmologists, helping to prevent overdiagnosis of conjunctival malignant melanoma in this young population.
针对亚洲人群的青少年结膜痣（JCN）进行的研究有限。本研究旨在调查中国西北部汉族人群中JCN病例的临床和病理特征，为病理学家和眼科医生诊断这种疾病提供见解。
确定并定义了一组儿童和青少年结膜痣，其特征为融合生长模式且缺乏成熟度。对这些病例的临床病理特征进行回顾性分析。
该研究纳入了40例年龄在3至20岁之间的患者，中位年龄为15.5岁。6例涉及先天性结膜色素沉着。男性患者24例，女性患者16例，男女比例为1.5:1。显微镜下，痣细胞在表皮内或表皮下融合生长，并表现出中度细胞异型性。在某些情况下，痣细胞团的融合会掩盖上皮与固有层的交界处，模拟上皮浸润，可能导致误诊。平均随访78.5个月，未观察到复发或术后并发症。
由于JCN在组织学上与结膜黑色素瘤相似，因此诊断具有挑战性。对JCN进行系统分析可以提高病理学家和眼科医生对其良性本质的认识，有助于防止对该年轻人群的结膜恶性黑色素瘤进行过度诊断。
