Epstein J I, Erlandson R A, Rosen P P
Am J Surg Pathol. 1984 Dec;8(12):907-15. doi: 10.1097/00000478-198412000-00003.
Three cases of blue nevi associated within lymph nodes were identified. These nodal blue nevi were all incidentally discovered in relation to axillary lymph nodes removed as part of modified radical mastectomy procedures for carcinoma of the breast. Only one lymph node from each axillary dissection contained the lesion. In one case, gross examination revealed black streaks in the capsule of the lymph node, providing the first reported macroscopic illustration of the blue nevus within the capsule of a lymph node. The lesions each occupied small portions of the lymph node capsules, with penetration into perinodal fibroadipose tissue in two cases and extension along intranodal fibrous trabeculae in the third case. Histologically, heavily pigmented dendritic and bipolar nevus cells were admixed with melanophages. Ultrastructural examination of one case documented the presence of mature melanosomes and possible basement membrane material. None of the patients had notable skin lesions and all were free of disease at last follow-up. Nodal blue nevi are probably an unusual variant of the nevus aggregate associated with lymph nodes. These lesions limited to the nodal capsule and supporting stroma should not be mistaken for malignant melanoma.
发现了3例伴有淋巴结的蓝色痣。这些淋巴结蓝色痣均是在因乳腺癌行改良根治性乳房切除术而切除腋窝淋巴结时偶然发现的。每次腋窝清扫仅一个淋巴结有病变。1例大体检查发现淋巴结包膜有黑色条纹，这是首次报道的淋巴结包膜内蓝色痣的宏观表现。病变均占据淋巴结包膜的小部分，2例病变穿入淋巴结周围纤维脂肪组织，第3例沿淋巴结内纤维小梁延伸。组织学上，色素沉着严重的树突状和双极痣细胞与噬黑素细胞混合存在。对1例进行超微结构检查，证实有成熟黑素小体和可能的基底膜物质存在。所有患者均无明显皮肤病变，最后一次随访时均无疾病。淋巴结蓝色痣可能是与淋巴结相关的痣聚集的一种罕见变体。这些局限于淋巴结包膜和支持基质的病变不应误诊为恶性黑色素瘤。
