Pathy A L, Helm T N, Elston D, Bergfeld W F, Tuthill R J
Department of Dermatology, Cleveland Clinic Foundation, Ohio.
J Cutan Pathol. 1993 Oct;20(5):459-64. doi: 10.1111/j.1600-0560.1993.tb00672.x.
A 65-year-old man presented with a history of a giant blue plaque of the parietal scalp since childhood. Biopsy revealed a cellular blue nevus. The blue nevus was observed for 10 years and thought to be unchanged until a new adjacent lesion was noted. Biopsy of the new lesion revealed metastatic malignant melanoma. A wide excision was performed of the original lesion which revealed malignant melanoma arising in a blue nevus. Areas within the blue nevus were consistent with a pilar neurocristic hamartoma, whereas other areas were consistent with a common blue nevus. Subsequent satellite metastases developed, with early metastases resembling blue nevi except for the absence of a stromal component and the presence of hyperchromatic nuclei. Later metastases were typical of metastatic melanoma. This case illustrates the uncommon evolution of malignant melanoma from a blue nevus. The histological features and relationship between melanoma, blue nevus, and pilar neurocristic hamartoma are reviewed.
一名65岁男性，自童年起即有顶叶头皮巨大蓝色斑块病史。活检显示为细胞性蓝色痣。该蓝色痣观察了10年，一直被认为无变化，直到发现一个新的相邻病变。新病变活检显示为转移性恶性黑色素瘤。对原病变进行了广泛切除，结果显示恶性黑色素瘤起源于蓝色痣。蓝色痣内的区域符合毛囊神经嵴错构瘤，而其他区域符合普通蓝色痣。随后出现卫星转移，早期转移灶除缺乏间质成分和存在核深染外，类似蓝色痣。后期转移灶为典型的转移性黑色素瘤。本病例说明了恶性黑色素瘤从蓝色痣演变而来的罕见情况。对黑色素瘤、蓝色痣和毛囊神经嵴错构瘤之间的组织学特征及关系进行了综述。
