1
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Bakker AC, Fishman SJ, Liang MG, Al-Ibraheemi A, Kozakewich HP, Mulliken JB, Slack JC. Immunohistochemical Expression of Lymphatic Endothelial Markers in Blue Rubber Bleb Nevus Syndrome. Pediatr Dev Pathol 2024; 27:228-234. [PMID: 38512910 DOI: 10.1177/10935266241228930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Blue rubber bleb nevus syndrome (BRBNS) is an uncommon vascular anomaly characterized by multifocal cutaneous, visceral, and other soft tissue or solid organ venous malformations. We observed that BRBNS lesions express immunohistochemical markers of lymphatic differentiation. METHODS BRBNS histopathologic specimens assessed at our institution during the past 27 years were reviewed. Slides from 19 BRBNS lesions were selected from 14 patients (9 cutaneous, 9 gastrointestinal, and 1 hepatic). We recorded the involved anatomical compartments and presence/absence of thrombi or vascular smooth muscle. Immunohistochemical endothelial expression of PROX1 (nuclear) and D2-40 (membranous/cytoplasmic) was evaluated semi-quantitatively. RESULTS Endothelial PROX1 immunopositivity was noted in all specimens; the majority (89.5%) demonstrated staining in more than 10% of cells. D2-40 immunopositivity was present in one-third (33%) of cutaneous lesions and only 1 gastrointestinal lesion. CONCLUSION Endothelial cells in BRBNS almost always express 1 or more immunohistochemical markers of lymphatic differentiation.
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MESH Headings
- Humans
- Nevus, Blue/metabolism
- Nevus, Blue/pathology
- Nevus, Blue/diagnosis
- Skin Neoplasms/pathology
- Skin Neoplasms/metabolism
- Skin Neoplasms/diagnosis
- Male
- Child
- Female
- Immunohistochemistry
- Child, Preschool
- Adolescent
- Gastrointestinal Neoplasms/metabolism
- Gastrointestinal Neoplasms/pathology
- Gastrointestinal Neoplasms/diagnosis
- Biomarkers, Tumor/metabolism
- Biomarkers, Tumor/analysis
- Infant
- Tumor Suppressor Proteins/metabolism
- Tumor Suppressor Proteins/analysis
- Homeodomain Proteins/metabolism
- Endothelium, Lymphatic/metabolism
- Endothelium, Lymphatic/pathology
- Antibodies, Monoclonal, Murine-Derived/metabolism
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Affiliation(s)
- Andrea C Bakker
- Departments of Pathology, Boston Children's Hospital, Boston, MA, USA
| | - Steven J Fishman
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Marilyn G Liang
- Department of Dermatology, Boston Children's Hospital, Boston, MA, USA
| | | | | | - John B Mulliken
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Jonathan C Slack
- Departments of Pathology, Boston Children's Hospital, Boston, MA, USA
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2
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Tseng C, Wiedemeyer K, Mehta A, Rojas-Garcia P, Temple-Oberle C, Orlando A, Miller K, Gharpuray-Pandit D, Brenn T. The clinico-pathological spectrum of plaque-type blue naevi and their potential for malignant transformation. Histopathology 2024; 84:1047-1055. [PMID: 38305122 DOI: 10.1111/his.15152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
AIMS Plaque-type blue naevi are rare melanocytic tumours presenting as large, pigmented plaques at birth or during childhood. There is a risk for malignant transformation, but no larger comprehensive studies exist and the diagnosis is challenging, especially on limited biopsy material. The aim is to describe the clinicopathological features and behaviour of the disease more comprehensively. METHODS AND RESULTS We retrieved eight plaque-type blue naevi, presenting as large, pigmented plaques (median = 7 cm; range = 3-26) most frequently affecting the scalp (four) followed by the cheek, arm, abdominal wall and gluteal cleft (one each), with a slight female predilection. Median age at time of biopsy was 39.5 years (range = 15-90), but three tumours had been present at birth and one since childhood. Histopathologically, the tumours were poorly circumscribed and composed of cellular fascicles of uniform spindle cells in a background of variably prominent pigmented dendritic cells affecting dermis and subcutaneous tissues. The majority had mutations in GNAQ. One tumour showed malignant transformation, characterised by an expansile nodule of pleomorphic epithelioid melanocytes with rhabdoid morphology, high mitotic activity and areas of necrosis. This patient developed metastatic melanoma to lymph nodes. All patients are alive with a median follow-up of 60 months. CONCLUSION Plaque-type blue naevi are diagnostically challenging tumours with risk for malignant transformation. Awareness and familiarity with the salient clinicopathological features are necessary for reliable diagnosis, and long-term clinical follow-up is required to monitor for malignant transformation.
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Affiliation(s)
- Calvin Tseng
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Katharina Wiedemeyer
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Arjun Mehta
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Claire Temple-Oberle
- Department of Surgery and Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Antonio Orlando
- Department of Plastic and Reconstructive Surgery, Southmead Hospital Bristol, Bristol, UK
| | - Keith Miller
- Department of Cellular Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | | | - Thomas Brenn
- Department of Pathology and Clinical Laboratories, Michigan Medicine, University of Michiga, Ann Arbor, MI, USA
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3
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Yumeen S, Mirza FN, Mirza HN, Zogg CK, Leventhal JS, Cohen JM. Malignant blue nevus: Characterization of US epidemiology and prognostic factors of a rare neoplasm with aggressive clinical course using the Surveillance, Epidemiology, and End Results Program database. J Am Acad Dermatol 2023; 89:843-846. [PMID: 37343827 DOI: 10.1016/j.jaad.2023.05.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/23/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023]
Affiliation(s)
- Sara Yumeen
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Humza N Mirza
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Cheryl K Zogg
- Yale School of Medicine, New Haven, Connecticut; Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Division of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, Connecticut.
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4
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Vanderbeck K, Rothrock AT, Cho WC, Nagarajan P, Aung PP, Hudgens C, Bassett RL, Ivan D, Prieto VG, Curry JL, Torres-Cabala CA. PRAME and LEF1 in Combined Deep Penetrating Nevus and Combined Blue Nevus: Utility and Pitfalls. Am J Dermatopathol 2023; 45:549-556. [PMID: 37462205 PMCID: PMC10534018 DOI: 10.1097/dad.0000000000002488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
ABSTRACT Deep penetrating nevi (DPN), particularly those showing combined features, or combined deep penetrating nevi (CDPN), may show histopathological resemblance to blue nevus (BN) and melanoma. Preferentially Expressed Antigen in MElanoma (PRAME) is a marker that helps distinguish melanoma from benign melanocytic lesions. Lymphoid enhancer-binding factor 1 (LEF1) has been proposed to be used in conjunction with β-catenin for diagnosis of DPN. The immunohistochemical expression of PRAME and LEF1 was evaluated in 10 DPN (including 6 CDPN and 2 DPN-like proliferations with atypical features), 16 BN (including combined and cellular BN), and 2 melanomas with features of DPN or BN. PRAME was negative in most DPN (n = 10/10, n = 9/10, one case with discrepancy between readers) and all BN (n = 16/16), while the 2 melanomas included were positive (n = 2/2). All DPN were positive for LEF1 (n = 9/9) while only a subset of BN were positive (n = 6/16, P = 0.0028; n = 5/16, P = 0.001, per both readers). LEF1 seemed to be easier to interpret than β-catenin because of its nuclear pattern of expression. The expression of LEF1 in the regular nevus component of combined BN presents a potential pitfall in practice because it may lead to misinterpretation of LEF1 as positive in the BN component of the lesion. However, a subset (approximately one-third) of combined BN seemed to show true LEF1 expression. Taking into account pitfalls in interpretation, the combinatorial panel of PRAME and LEF1, in addition to conventional histopathological features, may be useful to distinguish CDPN from combined BN and other benign and malignant mimics.
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Affiliation(s)
- Kaitlin Vanderbeck
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Aimi T Rothrock
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Woo Cheal Cho
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Phyu P Aung
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Courtney Hudgens
- Department of Translational Molecular Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Roland L Bassett
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Doina Ivan
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Victor G Prieto
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
- Department of Dermatology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jonathan L Curry
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
- Department of Translational Molecular Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
- Department of Dermatology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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5
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Lu VM, Luiselli GA, Parker T, Klinger NV, Sadegh C, See AP. Surgical considerations for spinal epidural hematoma evacuation in the setting of blue rubber bleb nevus syndrome in a child. Childs Nerv Syst 2023; 39:1691-1694. [PMID: 36862185 DOI: 10.1007/s00381-023-05843-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/09/2023] [Indexed: 03/03/2023]
Abstract
Blue rubber bleb nevus syndrome (BRBNS) is a rare condition that presents with venous malformation blebs throughout the body, most commonly on the skin and gastrointestinal tract. There have only been a limited number of reports of benign BRBNS lesions involving the spine in children, which were detected after chronic symptomatology. We herein present a unique case of a ruptured BRBNS venous malformation into the epidural space of the lumbar spine in a child presenting with acute neurologic deficit and discuss the relevant surgical considerations for operating in the setting of BRBNS.
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Affiliation(s)
- Victor M Lu
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, 33136, USA.
| | - Gabrielle A Luiselli
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Neurological Surgery, Brigham and Women's Hospitaland , Harvard Medical School, Boston, MA, USA
| | - Tariq Parker
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Neurosurgery, Massachusetts General Hospitaland, Harvard Medical School, MA, Boston, USA
| | - Neil V Klinger
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Cameron Sadegh
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Alfred P See
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
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6
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Allen NC, Paver EC, Agar N, Scolyer RA, Moloney FJ. A sheep in wolf's clothing: Agminated blue naevi masquerading as in-transit melanoma metastases. Australas J Dermatol 2023; 64:e196-e199. [PMID: 36840895 PMCID: PMC10952209 DOI: 10.1111/ajd.14002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/26/2023]
Affiliation(s)
- Nicholas C. Allen
- Department of DermatologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
- Central Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Elizabeth C. Paver
- Tissue Pathology and Diagnostic OncologyRoyal Prince Alfred Hospital and NSW Health PathologySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneySydneyNew South WalesAustralia
| | - Nita Agar
- Department of DermatologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Richard A. Scolyer
- Central Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Tissue Pathology and Diagnostic OncologyRoyal Prince Alfred Hospital and NSW Health PathologySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneySydneyNew South WalesAustralia
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Fergal J. Moloney
- Melanoma Institute AustraliaThe University of SydneySydneyNew South WalesAustralia
- Sydney Melanoma Diagnostic CentreRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
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7
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Colebatch AJ, Adhikari C, Diefenbach RJ, Rawson RV, Ferguson PM, Rizos H, Long GV, McCarthy SW, Thompson JF, Wilmott JS, Scolyer RA. Comprehensive Clinical, Histopathologic, and Molecular Analysis and Long-term Follow-up of Patients With Nodal Blue Nevi. Am J Surg Pathol 2022; 46:1048-1059. [PMID: 35439782 DOI: 10.1097/pas.0000000000001902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Blue nevi are benign, melanocytic neoplasms that show a range of clinical and morphologic patterns and include common/dendritic, cellular, and atypical cellular subtypes. Like other nevi, they most commonly occur in skin but can occasionally involve lymph nodes where they may be misinterpreted as representing metastatic melanoma. Moreover, whether benign blue nevi can metastasize to lymph nodes and their natural history and prognostic significance has been the subject of great controversy. To date, few cases of nodal blue nevi have been reported in the literature, and those reports have had limited clinical follow-up and supporting molecular data. This study sought to determine the clinical, pathologic, and molecular features of blue nevi involving lymph nodes, clarify their clinical significance, provide evidence for understanding their pathogenesis, and highlight potential pitfalls in the interpretation of lymph nodes with an ultimate aim of improving patient care. Thirteen cases of blue nevi involving lymph nodes were identified in the archives of Royal Prince Alfred Hospital, Sydney, Australia (1984-2018). A detailed assessment of the clinical and pathologic features of each case was performed, including an evaluation of all available immunohistochemical stains. Extended clinical follow-up was available for 9 patients. Droplet digital polymerase chain reaction for GNAQ Q209L, Q209P and GNA11 Q209L mutations was performed on 7 cases of blue nevi within lymph nodes together with matching cutaneous (presumed primary) blue nevi in 2 cases. All cases showed typical histologic features of blue nevi. BAP1 was retained in all cases (n=7). There were no recurrence or metastasis of blue nevus in any case on long-term clinical follow-up (n=9, median follow-up, 12 y). The majority of cases (n=5 of 7 evaluated) had GNAQ and GNA11 driver mutations. The 2 patients with a matched primary cutaneous blue nevus and regionally associated nodal blue nevus had the same GNAQ Q209L mutation in both sites in each patient. We conclude that blue nevi can involve lymph nodes and are associated with benign clinical behavior, and probably represent so-called "benign" metastasis. Awareness of these lesions is important when evaluating lymph nodes to avoid misdiagnosis as metastatic melanoma.
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Affiliation(s)
- Andrew J Colebatch
- Melanoma Institute Australia
- Faculty of Medicine and Health
- NSW Health Pathology
- Royal Prince Alfred Hospital
| | - Chandra Adhikari
- Melanoma Institute Australia
- Faculty of Medicine and Health
- NSW Health Pathology
| | - Russell J Diefenbach
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Robert V Rawson
- Melanoma Institute Australia
- Faculty of Medicine and Health
- NSW Health Pathology
- Royal Prince Alfred Hospital
| | - Peter M Ferguson
- Melanoma Institute Australia
- Faculty of Medicine and Health
- NSW Health Pathology
- Royal Prince Alfred Hospital
| | - Helen Rizos
- Melanoma Institute Australia
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Georgina V Long
- Melanoma Institute Australia
- Faculty of Medicine and Health
- Charles Perkins Centre, The University of Sydney
- Royal North Shore and Mater Hospitals
| | - Stanley W McCarthy
- Melanoma Institute Australia
- Faculty of Medicine and Health
- NSW Health Pathology
- Royal Prince Alfred Hospital
| | - John F Thompson
- Melanoma Institute Australia
- Faculty of Medicine and Health
- Royal Prince Alfred Hospital
| | - James S Wilmott
- Melanoma Institute Australia
- Faculty of Medicine and Health
- Charles Perkins Centre, The University of Sydney
| | - Richard A Scolyer
- Melanoma Institute Australia
- Faculty of Medicine and Health
- Charles Perkins Centre, The University of Sydney
- NSW Health Pathology
- Royal Prince Alfred Hospital
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8
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de la Fouchardiere A, Tirode F, Castillo C, Buisson A, Boivin F, Macagno N, Pissaloux D. Attempting to Solve the Pigmented Epithelioid Melanocytoma (PEM) Conundrum: PRKAR1A Inactivation Can Occur in Different Genetic Backgrounds (Common, Blue, and Spitz Subgroups) With Variation in Their Clinicopathologic Characteristics. Am J Surg Pathol 2022; 46:1106-1115. [PMID: 35319526 DOI: 10.1097/pas.0000000000001888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pigmented epithelioid melanocytoma is a rare cutaneous melanocytic proliferation considered high-grade melanocytoma in the 2018 WHO Classification of Skin Tumors. Little has been reported about the associated genetic drivers in addition to BRAF and MAP2K1 mutations or PRKCA gene fusions. Here, we present a series of 21 cases of PRKAR1A -inactivated melanocytic tumors in which we could assess the associated genetic background. We identified 9 different driver genes related to the common, Spitz, blue nevi, and PRKC -fused groups. Nine cases were associated with a canonical BRAF p.V600E mutation, a hallmark of the common nevus group. They occurred mainly in young adults. All were combined (biphenotypic) cases with a variable proportion of compound nevus. The pigmented epithelioid melanocytoma component was made of thin fascicules or isolated epithelioid cells covered by a dense hyperpigmented melanophage background and was predominantly located in the upper dermis. One such case was malignant. Six cases were associated with Spitz-related genetic anomalies ranging from HRAS or MAP2K1 mutations to gene fusions involving MAP3K8 , MAP3K3 , and RET . They occurred mainly in children and young adults. Morphologically, they showed large confluent junctional nests in a hyperplastic epidermis and a fascicular dermal component of spindled and epithelioid melanocytes with a frequent wedged silhouette. Intravascular invasion was observed in 4/6 cases. Five cases were associated with canonical mutations of the blue nevus group with 4 CYSLTR2 p.L129Q and 1 GNAQ p.Q209L mutations. They were removed mainly in adults and showed a frequent junctional component with epidermal hyperplasia. The dermal component showed dense fascicules of spindled and epithelioid melanocytes predominating over melanophages. One case occurred in a PRKCA -fused tumor in an adolescent with classic morphologic features. These results could potentially shift the concept of PRKAR1A -inactivated melanocytoma, changing from a rather unified model to a more complex one, including genetic subgroup variations with clinical and morphologic specificities. The genetic background of PRKAR1A -inactivated melanocytic tumors should be systematically explored to better understand the extent and clinical behavior of these complex lesions.
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Affiliation(s)
- Arnaud de la Fouchardiere
- Cancer Research Center of Lyon, INSERM 1052, CNRS 5286, Lyon University, Claude Bernard Lyon 1 University
- Biopathology Department, Cancer-care Center Léon Bérard, Unicancer, Lyon
| | - Franck Tirode
- Cancer Research Center of Lyon, INSERM 1052, CNRS 5286, Lyon University, Claude Bernard Lyon 1 University
- Biopathology Department, Cancer-care Center Léon Bérard, Unicancer, Lyon
| | | | - Adrien Buisson
- Biopathology Department, Cancer-care Center Léon Bérard, Unicancer, Lyon
| | - Felix Boivin
- Cancer Research Center of Lyon, INSERM 1052, CNRS 5286, Lyon University, Claude Bernard Lyon 1 University
| | - Nicolas Macagno
- Biopathology Department, Cancer-care Center Léon Bérard, Unicancer, Lyon
- Department of Pathology, Aix Marseille University, INSERM, APHM MMG, UMR1251, Marmara Institute, Timone University Hospital, Marseille, France
| | - Daniel Pissaloux
- Cancer Research Center of Lyon, INSERM 1052, CNRS 5286, Lyon University, Claude Bernard Lyon 1 University
- Biopathology Department, Cancer-care Center Léon Bérard, Unicancer, Lyon
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9
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Proietti I, Skroza N, Michelini S, Mambrin A, Anzalone A, Colapietra D, Volpe S, Tolino E, Marchesiello A, Balduzzi V, Maddalena P, Bernardini N, Porta N, Veccia N, Petrozza V, Potenza C. A case of proliferative nodule arising within blue nevus. Clin Ter 2022; 173:214-216. [PMID: 35612332 DOI: 10.7417/ct.2022.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Blue nevi are a heterogeneous group of lesions that can display a variety of different clinicopathological characteristics. Although attempts are made to classify each lesion into defined subtypes, there can be overlap between the subtypes. The clinical , dermoscopic and histolopathologic features of a case of proliferative nodule arising within blue nevus is discussed. Running title: Blue nevi are an heterogeneous group of melanocytic lesions blue tinctorial properties. Proliferative nodules are rare benign lesions often present at birth as a component of a large congenital melanocytic nevi, congenital or acquired nevi. We first report a case of proliferative nodule arising within blue nevus.
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Affiliation(s)
- I Proietti
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - N Skroza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - S Michelini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Mambrin
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Anzalone
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - D Colapietra
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - S Volpe
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - E Tolino
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Marchesiello
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - V Balduzzi
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - P Maddalena
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - N Bernardini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - N Porta
- Pathological Unit, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino I.C.O.T. Hospital, Latina, Italy
| | - N Veccia
- Pathological Unit, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino I.C.O.T. Hospital, Latina, Italy
| | - V Petrozza
- Pathological Unit, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino I.C.O.T. Hospital, Latina, Italy
| | - C Potenza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
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10
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Satake K, Sudo T, Sugino T, Yoshikawa S, Kiyohara Y, Hayashi T, Nakashima K, Goto K. Large Plaque-type Blue Nevus with GNAQ Q209P Mutation, Involving Mammary Gland Tissue: Under-Recognized Mammary Condition as an Origin of Primary Mammary Melanocytic Tumors. Am J Dermatopathol 2021; 43:e248-e253. [PMID: 34231495 DOI: 10.1097/dad.0000000000002010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Plaque-type blue nevus is a rare variant of blue nevi that was first described in 1954. This article presents clinical, macroscopic, histopathological, and genetic findings for a case of large plaque-type blue nevus expanding into the mammary gland tissue as well as the skin of the right breast. A 63-year-old woman presented with a congenital, large, blue-colored macule limited to the hypochondriac area of the right breast. A nodule 8 mm in diameter was also present in the mammary gland tissue. Magnetic resonance imaging was unable to detect diffuse melanin deposition in the mammary gland tissue, but pigmentation in the whole mammary parenchyma was observed in the cut surfaces of the mastectomy specimen. Histopathology revealed a sparse distribution of dendritic melanocytes in whole sections of the mammary fibrous tissue and partial sections of the dermis. The histopathological criteria for atypical cellular blue nevus were fulfilled for the mammary tumor. Nodal blue nevus was diagnosed in the sentinel lymph node. Sanger sequencing confirmed the GNAQ Q209P mutation, which was also identified in all 4 literature cases of plaque-type blue nevus, but rarely in conventional blue nevi and uveal melanoma. It should be noted that plaque-type blue nevus can expand into the mammary gland tissue, even if the pigmented lesion does not exist on the overlying breast skin. The mammary condition can be the origin of primary mammary melanocytic tumors. Mosaicism of the GNAQ Q209P mutation can be a characteristic genetic alteration to extensive blue nevi, including plaque-type blue nevus.
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Affiliation(s)
- Kosuke Satake
- Department of Dermatology, Shizuoka Cancer Center Hospital, Sunto, Japan
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Tamotsu Sudo
- Section of Translational Research, Hyogo Cancer Center, Akashi, Japan
- Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Takashi Sugino
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Shusuke Yoshikawa
- Department of Dermatology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Yoshio Kiyohara
- Department of Dermatology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Tomomi Hayashi
- Department of Breast Surgery, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Kazuaki Nakashima
- Department of Breast Imaging and Breast Interventional Radiology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Keisuke Goto
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
- Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan
- Department of Diagnostic Pathology, Tokyo Medical University Hospital, Tokyo, Japan
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
- Department of Diagnostic Pathology, Osaka National Hospital, Osaka, Japan ; and
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11
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Boven L, Noonan M, Sans-Cuellar H, Dela-Cruz N, Nathan C, Gungor A. Cellular blue nevus tumor presenting as a submandibular lymph node in a 16-year-old. Am J Otolaryngol 2021; 42:103139. [PMID: 34174671 DOI: 10.1016/j.amjoto.2021.103139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/13/2021] [Indexed: 11/18/2022]
Abstract
The cellular blue nevus tumor is a type of dendritic melanocytic nevus that is typically benign and exceedingly rare. The incidence of all blue nevi is about 1%, usually affecting the adult population and appearing on the extremities, sacrococcygeal or gluteal regions. There have only been a handful of case reports cited in the literature where cellular blue nevi present in the head and neck region, usually affecting the scalp and young adult population (7, 8). As such, it is exceedingly rare to encounter a cellular blue nevus tumor in the neck or infiltrating into neck lymph nodes. Here we report a rare case of a cellular blue nevus tumor presenting as a right neck mass in a pediatric 16-year-old patient, shown to invade into the submandibular lymph node and surrounding soft tissue. It is important to be aware of the cellular blue nevus tumor as a differential diagnosis in pediatric neck masses. Histological evaluation is necessary to determine tumor aggression and malignant potential which can guide further treatment in pediatric patients.
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Affiliation(s)
- L Boven
- Department of Otolaryngology-H&N Surgery, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA.
| | - M Noonan
- Department of Otolaryngology-H&N Surgery, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA
| | - H Sans-Cuellar
- Department of Radiology, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA
| | - N Dela-Cruz
- Department of Pathology, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA
| | - C Nathan
- Department of Otolaryngology-H&N Surgery, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA
| | - A Gungor
- Department of Otolaryngology-H&N Surgery, Louisiana State University Health-Shreveport, 1501 King's Highway, Shreveport, LA 71130, USA
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12
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Sheahon KM, Jankowski T, Yeh I, North JP, Pincus LB, LeBoit PE, McCalmont TH, Lang UE. Primary Cilia Are Preserved in Cellular Blue and Atypical Blue Nevi and Lost in Blue Nevus-like Melanoma. Am J Surg Pathol 2021; 45:1205-1212. [PMID: 34265802 DOI: 10.1097/pas.0000000000001739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Distinguishing cellular blue nevi (CBNs) and atypical CBNs from blue nevus-like melanoma (BNLM) can be diagnostically challenging. Immunohistochemistry may inform the diagnosis in a subset of cases but is not always diagnostic. Further, ancillary molecular testing is expensive and often requires significant tissue to complete. Primary cilia are cell-surface organelles with roles in signal transduction pathways and have been shown to be preserved in conventional melanocytic nevi but lost in melanoma. Immunofluorescence staining of primary cilia can be performed using a single standard-thickness formalin-fixed paraffin-embedded tissue section and has a turnaround time similar to immunohistochemistry. The percentage of tumoral melanocytes retaining a primary cilium is quantified and reported as the ciliation index. In the current study, we explored the utility of the ciliation index in a series of 31 blue nevus-like lesions, including CBNs (12), atypical CBNs (15), and BNLM (4). The average ciliation index for the CBNs was 59±18%, with a median of 60 (range: 28 to 87). The average ciliation index for atypical CBNs was 59±23, with a median of 59 (range: 20 to 93). The average ciliation index for BNLM was 4±3, with a median of 3 (range: 1 to 8). There was no significant difference in ciliation index between the CBN and atypical CBN categories. There was a significant difference between CBN and BNLM and between atypical CBNs and BNLM (P<0.001 for each). Here, we show that ciliation index is a quantitative diagnostic tool useful in the setting of blue nevus-like neoplasms, with benefits including cost and time efficiency.
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Affiliation(s)
| | | | - Iwei Yeh
- Departments of Pathology
- Dermatology, University of California, San Francisco
| | - Jeffrey P North
- Departments of Pathology
- Dermatology, University of California, San Francisco
| | - Laura B Pincus
- Departments of Pathology
- Dermatology, University of California, San Francisco
| | - Philip E LeBoit
- Departments of Pathology
- Dermatology, University of California, San Francisco
| | - Timothy H McCalmont
- Departments of Pathology
- Dermatology, University of California, San Francisco
| | - Ursula E Lang
- Departments of Pathology
- Department of Pathology, Zuckerberg San Francisco General Hospital, San Francisco, CA
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13
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Chan MMH, Tan DJA, Liang MW, Tan LS. A Pigmented Nevus in a Young Child. Skinmed 2020; 18:394. [PMID: 33397575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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14
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Piccolo V, De Barros M, Corneli P, de Almeida Costa Sartoretto B, Russo T, Zalaudek I, Alfano R, Argenziano G. Dermoscopy of blue naevus on acral volar skin: A review of the literature. Australas J Dermatol 2019; 60:336-338. [PMID: 30724334 DOI: 10.1111/ajd.12999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Vincenzo Piccolo
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Mayara De Barros
- Professor Rubem David Azulay Institute, Charity Hospital of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paola Corneli
- Department of Dermatology, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | | | - Teresa Russo
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Iris Zalaudek
- Department of Dermatology, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | - Roberto Alfano
- Department of Anesthesiology, Surgery and Emergency, University of Campania Luigi Vanvitelli, Naples, Italy
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15
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Eniu DT, Staicu A, Şomcutian O, Buiga R, Albu C, Goidescu IG, Chiorean AR, Nistor-Ciurba CC. Blue nevus-like melanoma of the uterine cervix. Case report and review of the literature. Rom J Morphol Embryol 2019; 60:1317-1321. [PMID: 32239111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We present the clinical and pathological aspects of a patient diagnosed with a very rare tumor, a blue nevus-like melanoma of the uterine cervix. The patient turned to our Service for a second opinion regarding a cervical polyp causing vaginal bleeding, polyp which has been excised in another Hospital and interpreted initially as a pleomorphic sarcoma. In the presentation, we emphasize upon the stages of solving a difficult diagnosis, pathological description and treatment of these rare, aggressive tumors with poor prognosis, which represent the fundamental precondition in order to formulate the best therapeutic strategy.
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Affiliation(s)
- Dan Tudor Eniu
- 1st Department of Obstetrics and Gynecology, Faculty of Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania;
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16
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Griewank KG, Koelsche C, van de Nes JAP, Schrimpf D, Gessi M, Möller I, Sucker A, Scolyer RA, Buckland ME, Murali R, Pietsch T, von Deimling A, Schadendorf D. Integrated Genomic Classification of Melanocytic Tumors of the Central Nervous System Using Mutation Analysis, Copy Number Alterations, and DNA Methylation Profiling. Clin Cancer Res 2018; 24:4494-4504. [PMID: 29891723 DOI: 10.1158/1078-0432.ccr-18-0763] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/28/2018] [Accepted: 06/05/2018] [Indexed: 11/16/2022]
Abstract
Purpose: In the central nervous system, distinguishing primary leptomeningeal melanocytic tumors from melanoma metastases and predicting their biological behavior solely using histopathologic criteria may be challenging. We aimed to assess the diagnostic and prognostic value of integrated molecular analysis.Experimental Design: Targeted next-generation sequencing, array-based genome-wide methylation analysis, and BAP1 IHC were performed on the largest cohort of central nervous system melanocytic tumors analyzed to date, including 47 primary tumors of the central nervous system, 16 uveal melanomas, 13 cutaneous melanoma metastases, and 2 blue nevus-like melanomas. Gene mutation, DNA-methylation, and copy-number profiles were correlated with clinicopathologic features.Results: Combining mutation, copy-number, and DNA-methylation profiles clearly distinguished cutaneous melanoma metastases from other melanocytic tumors. Primary leptomeningeal melanocytic tumors, uveal melanomas, and blue nevus-like melanoma showed common DNA-methylation, copy-number alteration, and gene mutation signatures. Notably, tumors demonstrating chromosome 3 monosomy and BAP1 alterations formed a homogeneous subset within this group.Conclusions: Integrated molecular profiling aids in distinguishing primary from metastatic melanocytic tumors of the central nervous system. Primary leptomeningeal melanocytic tumors, uveal melanoma, and blue nevus-like melanoma share molecular similarity with chromosome 3 and BAP1 alterations, markers of poor prognosis. Clin Cancer Res; 24(18); 4494-504. ©2018 AACR.
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Affiliation(s)
- Klaus G Griewank
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Germany.
- Dermatopathologie bei Mainz, Nieder-Olm, Germany
| | - Christian Koelsche
- Department of Neuropathology, Ruprecht-Karls-University Heidelberg, and Clinical Cooperation Unit Neuropathology, and DKTK, DKFZ, Heidelberg, Germany.
| | | | - Daniel Schrimpf
- Department of Neuropathology, Ruprecht-Karls-University Heidelberg, and Clinical Cooperation Unit Neuropathology, and DKTK, DKFZ, Heidelberg, Germany
| | - Marco Gessi
- Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany
- Division of Histopathology, Fondazione Policlinico Universitario "A.Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy
| | - Inga Möller
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Germany
| | - Antje Sucker
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Germany
| | - Richard A Scolyer
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- The University of Sydney, Camperdown, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
| | - Michael E Buckland
- The University of Sydney, Camperdown, NSW, Australia
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Rajmohan Murali
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Torsten Pietsch
- Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Ruprecht-Karls-University Heidelberg, and Clinical Cooperation Unit Neuropathology, and DKTK, DKFZ, Heidelberg, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Germany
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17
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Benson KA, Crandall M, Spring LK. Agminated heterogeneous papules on the neck. Cutis 2018; 102:E24-E26. [PMID: 30235370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Kenneth A Benson
- Naval Medical Center San Diego, California; and Combat Logistics Regiment 1, 1st Marine Logistics Group, Camp Pendleton, California, USA
| | - Michael Crandall
- Dermatology Department, Naval Hospital Camp Lejeune, North Carolina, USA
| | - Leah K Spring
- Dermatology Department, Naval Hospital Camp Lejeune, North Carolina, USA
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18
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Kutbay NO, Yurekli BS, Sever A, Ceylan C. Nevus-like lesions on the lip and the foot. Eur J Intern Med 2018; 53:e6-e7. [PMID: 29336867 DOI: 10.1016/j.ejim.2017.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/31/2017] [Indexed: 11/18/2022]
Affiliation(s)
| | - Banu Sarer Yurekli
- Ege University, Faculty of Medicine, Endocrinology Department, Izmir, Turkey
| | - Ahmet Sever
- Ege University, Faculty of Medicine, Radiology Department, Izmir, Turkey.
| | - Can Ceylan
- Ege University, Faculty of Medicine, Dermatology Department, Izmir, Turkey.
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19
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Zor M, Kaya E. Cellular Blue Nevus: An Unusual Localization. Skinmed 2017; 15:463. [PMID: 29282187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Murat Zor
- Department of Urology, Gulhane Training and Research Hospital, Kecıoren, Turkey,
| | - Engin Kaya
- Department of Urology, Gulhane Training and Research Hospital, Kecıoren, Turkey
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Abstract
The aim of our study is to enhance the awareness of blue rubber bleb nevus syndrome (BRBNS) through the patients in our hospital and introduced a new measure of endoscopic intervention.A retrospective review of 5 patients, who were diagnosed as BRBNS in our hospital from January 2013 to January 2017, was conducted. Data were collected with regard to demographics, clinical presentation, endoscopic and imaging findings, management, and follow-up data.In total of 5 patients, the mean age was 28.8 years, range 16 to 44 years (male/female, 1/4) with the average initial age of onset 15.4 years. No family history was identified in our group. Physical examination showed multiple cutaneous lesions in 2 patients (40%, 2/5). All the 5 patients had gastrointestinal tract vascular malformations; stomach involved in 2 cases, large intestine in 2 cases, and small intestine involved in 3 cases. Lesions in the visceral organs and tissue were found in 1 patient. Gastrointestinal bleeding was its main symptom (3/5, 60%). Laboratory investigations revealed anemia in 4 patients and abnormality of coagulopathy in 2 patients with severe anemia. Conservative approach was recommended in 3 cases that included iron supplementation, drug hemostasis, and/or blood transfusion. An innovatively therapeutic approach with endoscopic submucosal dissection (ESD) procedure was used successfully in 1 patient with 2 polypoid BRBNS lesions in rectum.BRBNS is a very rare vascular malformation syndrome with unclear etiopathogenesis and noncurative treatments. ESD procedure was a feasible approach to remove the partial gastrointestinal lesions.
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Affiliation(s)
- Wenguo Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Hongtan Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Guodong Shan
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Ming Yang
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Fengling Hu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Qi Li
- Department of Nephrology, Jilin City Central Hospital, Jilin, Jilin Province, China
| | - Lihua Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Guoqiang Xu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
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21
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He T, Mao C, Xu D, Yan H. Cellular Blue Nevus of Perilimbal Conjunctiva: A Case Report and Review of Literature. Ann Clin Lab Sci 2017; 47:477-480. [PMID: 28801376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cellular blue nevus is an uncommon neoplasm in the conjunctiva. Here we present an unusual case of a cellular blue nevus that clinically resembled conjunctival melanoma. A 29-year-old Chinese male was found to have a giant pigmented lesion of the conjunctiva around the limbal area of right eye from birth. Excisional biopsy with no-touch technique, lamellar corneal transplantation, amniotic membrane transplantation and adjuvant cryotherapy were performed. Histopathology revealed a nodular, well-defined tumor, which was composed of heavily pigmented dendritic cells and less pigmented spindle cells. There was no recurrence during eight years follow-up. Cellular blue nevus of conjunctiva can be wrongly diagnosed as conjunctival melanoma due to atypia criteria. Therefore, it is important to understand its clinical and pathological characteristics to avoid an overtreatment.
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Affiliation(s)
- Tiangeng He
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin China
| | - Chunjie Mao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin China
| | - Dongbo Xu
- Department of Pathology, Tianjin Medical University General Hospital, Tianjin China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin China
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22
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Borgenvik TL, Karlsvik TM, Ray S, Fawzy M, James N. Blue nevus-like and blue nevus-associated melanoma: a comprehensive review of the literature. ANZ J Surg 2017; 87:345-349. [PMID: 28318130 DOI: 10.1111/ans.13946] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/24/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Malignant blue nevus, blue nevus-associated melanoma and blue nevus-like melanoma are all terms used to describe malignant melanomas arising from, in association with, or resembling blue nevi. This review is aimed at summarizing the available literature to reduce the confusion surrounding this rare malignancy, and aid the surgeon in choosing further diagnostic or therapeutic measures. METHODS We conducted a search of Medline, Embase, Science Direct, Scopus and the Cochrane Library for all full text articles published in English that reported on a malignant melanoma arising from, in association with, or resembling a blue nevus. RESULTS We identified 91 cases that fit the criteria above. The mean age at diagnosis was 45 years, with a slight male predominance (males: 48; females: 43). Metastatic cases were reported in 55% (n = 50), of which 16 were metastatic at the time of diagnosis, 16 developed metastases within the first year and 18 within 5 years of initial diagnosis. The mean Breslow thickness was 6.8 mm at the time of diagnosis (n = 39). CONCLUSIONS The histological criteria for diagnosing this malignancy are very poorly defined, and may contribute to the substantial confusion surrounding the terminology. There is no consensus on which prognostic indicators predictive of outcome in 'conventional' malignant melanoma are applicable to blue nevus-like melanoma/blue nevus-associated melanoma. However, two larger case series have demonstrated a significant association between Breslow thickness (or largest tumour dimension when non-epidermal) and recurrence-free survival, as well as rate of local recurrence, but larger studies are needed to confirm this.
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Affiliation(s)
| | - Tina M Karlsvik
- Department of Surgery, Ostfold Hospital Trust, Kalnes, Norway
| | - Saikat Ray
- Department of Plastic Surgery, St. Andrew's Centre for Burns and Plastic Surgery, Chelmsford, UK
| | - Monica Fawzy
- Department of Plastic Surgery, Norfolk and Norwich University Hospitals, Norwich, UK
| | - Nick James
- Department of Plastic Surgery, East and North Hertfordshire NHS Trust, Stevenage, UK
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23
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Klufas DM, Que SKT, Berke A, Maryland BS. Acquired blue nevus of the nail bed. Dermatol Online J 2017; 23:13030/qt66c1m1hm. [PMID: 28329489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 06/06/2023] Open
Abstract
Blue nevi are benign proliferations of melaninproducingdendritic melanocytes located in thedermis. These nevi tend to occur mostly on the skin,predominantly on the head and neck, dorsal aspectsof the distal extremities, and the sacral area, butcan also occasionally appear on mucosal surfaces.Blue nevi of the nail apparatus are uncommon. Themajority originate in the nail matrix where there is ahigher density of melanocytes. Herein we report ona 47-year-old man with a rare common blue nevus ofthe nail bed, an area with low melanocyte density. Athorough review of the English language literaturefound no documented cases of acquired blue nevioriginating in the nailbed of the toe.
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Affiliation(s)
| | | | | | - Brett Sloan Maryland
- Department of Dermatology, University of Connecticut Health Center, Farmington. Steven.Sloan@ va.gov
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24
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Yamada S, Nawata A, Yoshioka M, Hiraki T, Higashi M, Hatanaka K, Tanimoto A. Complete regression of primary cutaneous malignant melanoma associated with distant lymph node metastasis: a teaching case mimicking blue nevus. BMC Res Notes 2016; 9:366. [PMID: 27456492 PMCID: PMC4960676 DOI: 10.1186/s13104-016-2174-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/21/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Malignant melanoma (MM) tends to be spontaneously regressed, however, complete regression of primary cutaneous MM is an extremely rare phenomenon. Our aim is to be aware that pathologists and/or dermatologists can readily misinterpret it as the other benign or malignant lesions. CASE PRESENTATION A gradually growing and verrucous hypopigmented macule had been noticed in the right sole of a 65-year-old Japanese male since 2 years before, and it turned to be a solitary bluish to black patch with surrounding depigmentation and was recently decreased in size. In parallel, the patient had a rapidly growing black-pigmented mass lesion at the right inguen. The cutaneous specimen from the sole showed an aggregation of many melanophages predominantly in the middle to deep layer of dermis, associated with surrounding fibrosis, reactive vascular proliferation and CD8-positive T-lymphocytic infiltrate, covered by attenuated epidermis with absence of rete ridge. However, no remnant MM cells were completely seen in the step-serial sections. We first interpreted it as blue nevus. By contrast, the inguinal mass revealed a diffuse proliferation of highly atypical mono- to multi-nucleated large cells having abundant eosinophilic cytoplasm in the enlarged lymph node tissue. Immunohistochemical findings demonstrated that these atypical cells were specifically positive for HMB45 and Melan A. Therefore, we finally made a diagnosis of complete regression of primary cutaneous MM associated with distant lymph node metastasis of MM. CONCLUSION Careful, not only general/cutaneous but histopathological, examinations should be necessary and adjunctive aids for reaching the correct diagnosis of complete regression of cutaneous MM.
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Affiliation(s)
- Sohsuke Yamada
- Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Aya Nawata
- Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Manabu Yoshioka
- Department of Dermatology and Immunology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tsubasa Hiraki
- Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Michiyo Higashi
- Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuhito Hatanaka
- Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihide Tanimoto
- Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Paolino G, Didona D, Lopez T, Alesini F, Cantisani C, Richetta AG, Soda G, Calvieri S. Agminated Blue Nevus: Two Case Reports and a Mini-review of the Literature. Acta Dermatovenerol Croat 2016; 24:37-41. [PMID: 27149129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Agminated blue nevus (ABN) is a melanocytic nevus rarely mentioned in the literature and not well known. The term agminated is used when many blue nevi are clustered together in a sharply demarcated area ≤10 cm. Specific dermatoscopic features have not currently been clearly defined. We describe two cases of ABN and provide a review of the literature, reporting the main points in order to facilitate the diagnosis of this rare entity.
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Affiliation(s)
| | - Dario Didona
- Dario Didona, MD, Viale del Policlinico, 155, 00186 Rome, Italy;
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26
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Ayala D, Ramón MD, Cabezas M, Jordá E. Nevus Spilus Associated with Agminated Blue Nevus: A Rare Combination. Actas Dermosifiliogr 2016; 107:614-6. [PMID: 27001348 DOI: 10.1016/j.ad.2016.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/13/2016] [Accepted: 01/27/2016] [Indexed: 11/19/2022] Open
Affiliation(s)
- D Ayala
- Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España.
| | - M D Ramón
- Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - M Cabezas
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España
| | - E Jordá
- Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
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27
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Ehara Y, Yoshida Y, Shiomi T, Yamamoto O. Pigmented Dermatofibrosarcoma Protuberans and Blue Naevi with Similar Dermoscopy: A Case Report. Acta Derm Venereol 2016; 96:272-3. [PMID: 26258458 DOI: 10.2340/00015555-2204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yuko Ehara
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, , Japan.
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28
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Ferenczi K, Kristjansson A, Grant-Kels JM. Linear bluish-black papules on the shoulder. Cutis 2015; 96:E10-E12. [PMID: 26682561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Katalin Ferenczi
- Department of Dermatology and Dermatopathology, University of Connecticut Health Center, Farmington, USA
| | - Arni Kristjansson
- Department of Dermatology and Dermatopathology, University of Connecticut Health Center, Farmington, USA
| | - Jane M Grant-Kels
- Department of Dermatology and Dermatopathology, University of Connecticut Health Center, Farmington, USA
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29
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Abstract
Nevus of Ota, also known as oculodermal melanocytosis, is a congenital pigmentary condition that can affect structures in the distribution of the ophthalmic and maxillary divisions of the trigeminal cranial nerve. Malignant transformation, although rare, may occur within nevus of Ota and result in uveal, cutaneous, orbital or even dural melanoma. We present a new association of Nevus of Ota complicated with a giant orbital Blue Nevus in a young white male and the management of this tumor.
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Affiliation(s)
- Ramón Medel
- Ophthalmic Plastic Surgery Department, Instituto de Microcirugia Ocular , Barcelona , Spain
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30
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Perez-Lopez I, Garrido-Colmenero C, Blasco-Morente G, Aneiros-Fernandez J, Arias-Santiago S. [Utility of skin ultrasound in the differential diagnosis of blue lesions, hydrocysts]. Dermatol Online J 2015; 21:13030/qt2mw2m8b0. [PMID: 25933080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 06/04/2023] Open
Abstract
Many skin diseases may present as blue papules and nodules; the differential diagnosis includes such different entities such as metastatic melanoma, angioma, lipoma, epidermoid cyst, pilomatrixoma, blue nevus, glomus tumor, or hidrocystoma. Cutaneous ultrasound can be a complementary diagnostic technique of great value in these cases.
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Affiliation(s)
- Israel Perez-Lopez
- Unidad de Gestión Clínica de Dermatología Médico Quirúrgica y Venereología. Hospital Universitario Virgen de las Nieves.
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31
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Abstract
Blue rubber-bleb nevus syndrome (BRBNS), or Bean's syndrome, is a rare angiomatosis characterized by multiple cavernous hemangiomas of the skin, mucosae and frequently of other sites. A 49-year-old male patient had been affected since birth by multiple angiomas localized in the skin, lips, oral cavity, cranial theca, and central nervous system; intrauterine rupture of angiomas in the right parietal lobe had caused partial hypotrophic paralysis of the left hemisoma. In addition to BRBNS, the patient was affected by three osteoid osteomas: this never-described clinical association is here discussed.
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Sardana K, Sagar V. Blue nevus on the scalp. Indian Pediatr 2014; 51:84. [PMID: 24561475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Kabir Sardana
- Departments of Dermatology, Maulana Azad Medical College, New Delhi, India. and *ESI Model Hospital, Gurgaon, Haryana, India.
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33
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Affiliation(s)
- Andrea Taddio
- Institute for Maternal and Child Health-IRCCS, Burlo Garofolo-Trieste, University of Trieste, Trieste, Italy
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Sadayasu A, Fujimura T, Haga T, Kambayashi Y, Furudate S, Aiba S. Pigmented epithelioid melanocytoma: immunohistochemical profiles of tumour-infiltrating histiocytes. Acta Derm Venereol 2013; 93:481-2. [PMID: 23165929 DOI: 10.2340/00015555-1507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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35
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Kachare SD, Agle SC, Englert ZP, Zervos EE, Vohra NA, Wong JH, Fitzgerald TL. Malignant blue nevus: clinicopathologically similar to melanoma. Am Surg 2013; 79:651-656. [PMID: 23815995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Malignant blue nevus (MBN) is a rare melanocytic lesion and controversy exists whether it is a melanoma or a unique entity. We sought to establish clinical behavior using a large national registry. All patients with MBN and melanoma from 1973 to 2008 were identified in the Surveillance Epidemiology and End Results tumor registry. We performed comparative and survival analysis among the two tumor types. A total of 228,038 patients were identified (227,986 with melanoma and 52 with MBN). The mean age was 57.7 years. Both lesions had similar age of presentation (55.8 vs 55.7 years, P = 0.527), sex (male 50 vs 55%, P = 0.44), and nodal positivity rate (9.6 vs 5.4%, P = 0.22). MBNs were more likely to be nonwhite (11.8 vs 1.6%, P < 0.0001) and present with metastatic disease (15.2 vs 4%, P = 0.0028). MBN and melanoma had a similar survival (264 vs 240 months, P = 0.78) and remained similar when stratified by race (264 vs 242 months, P = 0.99) and stage (264 vs 256 months, P = 0.83). This is the largest study to date demonstrating similar clinical behavior and survival between patients with MBN and those with melanoma. We believe MBN is a variant of melanoma and suggest using a similar treatment algorithm as that of melanoma.
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Affiliation(s)
- Swapnil Dilip Kachare
- Division of Surgical Oncology, East Carolina University, Brody School of Medicine, Greenville, North Carolina 27834, USA.
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36
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Long Q, Ma M, Chen J. [Report of a case with pediatric blue rubber Bleb nevus syndrome]. Zhonghua Er Ke Za Zhi 2013; 51:152-153. [PMID: 23527985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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38
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Baderca F, Mateş I, Solovan C. Unusual variant of blue nevus associated with dermatofibromas. Rom J Morphol Embryol 2013; 54:413-417. [PMID: 23771090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The blue nevus is a variant of a melanocytic nevus that presents as blue-gray to blue or black papules or nodules measuring up to 1 cm in diameter; it has a predilection for females and can be congenital or acquired. The classification of blue nevi is complex, with biological behavior being benign, borderline, or malignant. The case we present is one of a 40-year-old woman with multiple dermatofibromas that appeared and increased gradually in size during pregnancy. Physical examination revealed three spherical, brownish to red-purple nodules localized on the left leg, right shoulder and right laterocervical area. In addition, on her right forearm, there was a 0.3 cm nodule with a discreet non-pigmented, elevated area and a blue perilesional border that appeared in her childhood, affirmative after stinging herself with a pencil. The patient's family history was negative for significant lesions. The laboratory and imagistic findings were normal. Four skin biopsies were performed. The histopathological examination revealed an uncommon blue nevus with two different populations of pigmented cells: spindle shaped or dendritic melanocytes diffuse distributed in the middle dermis and closely aggregated deeply pigmented melanocytes in the reticular dermis. The other three lesions were diagnosed as dermatofibromas: bland spindle shaped cells in a fibrous stroma, some cells with a storiform arrangement. The overlying epidermis was hyperplastic with acanthosis and hyperpigmentation of the basal cell layer. No mitoses were seen.
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Affiliation(s)
- Flavia Baderca
- Department of Microscopic Morphology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
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39
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40
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Kim JK, Nelson KC. Dermoscopic features of common nevi: a review. GIORN ITAL DERMAT V 2012; 147:141-148. [PMID: 22481577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The differentiation between benign and worrisome melanocytic lesions may be challenging in the absence of the glaringly obvious clinical features that define a cutaneous malignancy. In such situations, dermoscopy may prove useful in further defining characteristics that are more indicative of a benign lesion, which can ultimately help avoid an unnecessary biopsy. Recognizing of the dermoscopic findings of benign nevi, taking into consideration the predominant pigment pattern and its organization, may aid in the evaluation of pigmented lesions. Benign nevi tend to exhibit symmetry, regularity in shape, and uniformity of dermoscopic structures. This article reviews the clinical and dermoscopic features of common acquired nevi (dermal, compound, and junctional), blue nevi, and congenital nevi.
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Affiliation(s)
- J K Kim
- Department of Dermatology, Duke University Medical Center, Durham, NC 27710, USA
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41
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42
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Pigac B, Marić S, Mašić S. Benign blue naevus of the lungs. Med Glas (Zenica) 2012; 9:130-132. [PMID: 22634927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 07/15/2011] [Indexed: 06/01/2023]
Abstract
Blue naevus is a dark blue, gray or black lesion consisted of dermal melanocytes and usually found on face, scalp, or on the dorsum of hands and feet. Two well defined histologic and clinical variants, designated as "common" and "cellular", have been recognised. An unusual case of accidentally detected common blue naevus of the lungs has been reported. The specimen of lung tissue was taken during autopsy of a 62-year old woman who died of myocardial infarction. Microscopic analysis revealed the area containing melanocytes filled with melanin pigment.
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Affiliation(s)
- Biserka Pigac
- Pathology, Citology and Forensic Medicine Unit, Varaždin General Hospital, Varaždin, Croatia.
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43
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Abstract
A 58-year-old man with clinical diagnosis of phacomatosis pigmentovascularis (PPV) experienced tinnitus and progressive hearing loss due to a jugular foramen tumor.Attached to the tumor capsule, were several pigmented spots. Pathological examination revealed a tumor composed by two different tissues, namely a Schwannoma grade I associated with a leptomeningeal blue nevus. The neuropathological aspects of this unusual association are discussed. The association of PPV with a pigmented skull base tumor has not been described to date and illustrates the importance of systemic examination in PPV.
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44
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Raspollini MR, Masieri L, Tosi N, Santucci M. Blue nevus of the prostate: incidental finding in radical prostatectomy specimen with a pre-operative echographic image of peripheral hypoechogenic nodule. Arch Ital Urol Androl 2011; 83:210-212. [PMID: 22670321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Blue nevus is a stromal melanin deposition, which is microscopically characterized by deeply pigmented melanin-filled spindle cells within the fibromuscular stroma. Cases with prominent melanosis such as those with grossly visible pigment are uncommon. Melanocytic lesions of the prostate are incidental findings with no evidence of malignant transformation. There have only been very few reports of a malignant melanoma of primary prostatic origin. We report an incidental finding of a blue nevus of the prostate, in a radical prostatectomy specimen, in a 64-years-old man with a pre-operative ecographic image of peripheral hypoechogenic nodule. The are very few reports of blue nevi associated to prostatic adenocarcinoma, but none has been evidentiated before surgery as a distinct ultrasound lesion interpreted as adenocarcinoma, therefore inducing the clinician to perform biopsies and consequently a radical prostatectomy.
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Affiliation(s)
- Maria Rosaria Raspollini
- Division of Histology and Molecular Diagnostics, University Hospital Careggi, University of Florence, Florence, Italy.
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45
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Diehl JW, Berk DR, Ney A, Bayliss SJ. Diffuse dermal melanocytosis: follow-up 30 years later with novel findings of eruptive blue nevi. ACTA ACUST UNITED AC 2011; 147:1339-40. [PMID: 22106135 DOI: 10.1001/archdermatol.2011.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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46
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Murata T, Kaku Y, Morita K. Common blue nevus on the upper lip: a case report. J Dermatol 2011; 39:419-20. [PMID: 22032727 DOI: 10.1111/j.1346-8138.2011.01294.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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47
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Beristain-Hernández JL, Rojano-Rodríguez A. [Capsule endoscopy images in blue rubber bleb nevus syndrome]. Rev Gastroenterol Mex 2011; 76:362-363. [PMID: 22188962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- J L Beristain-Hernández
- Servicios de Cirugía Endoscópica, Hospital General Dr. Manuel Gea González, Secretaría de Salud, México, D. F.
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48
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Marín-Manzano E, Utrilla López A, Puras Magallay E, Cuesta Gimeno C, Marín-Aznar JL. Cervical cystic lymphangioma in a patient with blue rubber bleb nevus syndrome: clinical case report and review of the literature. Ann Vasc Surg 2011; 24:1136.e1-5. [PMID: 21035709 DOI: 10.1016/j.avsg.2010.02.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 01/16/2010] [Accepted: 02/08/2010] [Indexed: 01/10/2023]
Abstract
We present the case of a 9-year-old boy diagnosed with blue rubber bleb nevus syndrome, who showed a very large left cervical cystic lymphangioma. He was previously subjected to various treatments for lesions in the intestinal tract including blood transfusions for anemia, sclerosis, enterotomies or resections. The tumor was resected without any complications and the anatomopathologic report confirmed this diagnosis. The blue cavernous hemangioma syndrome (or blue rubber bleb nevus syndrome) is a rare disease characterized by cavernous angiomas involving the skin and gastrointestinal tract. Several cases of cystic lymphangiomas associated with this syndrome have been published recently and lymphomatous differentiation has been identified in the cells of cutaneous lesions. Given their common embryological origin, we underscore the importance of bearing in mind that it is possible for different types of vascular malformations to coexist in the same patient.
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Affiliation(s)
- Elena Marín-Manzano
- Angiology and Vascular Surgery Service, Ramón y Cajal Hospital, Madrid, Spain.
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49
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Marti-Mestre J, Cañis-Sánchez D, Jaén-Martínez JM, Bosch Princep R. [Prostatic blue nevus. An infrequent histologic diagnosis]. Actas Urol Esp 2010; 34:899-901. [PMID: 21159289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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50
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Turk BG, Turkmen M, Karaarslan IK, Aydogdu S, Akalin T, Ozdemir F. Blue rubber bleb nevus syndrome: a case report with dermatoscopic features. Clin Exp Dermatol 2010; 36:211-3. [PMID: 20825430 DOI: 10.1111/j.1365-2230.2010.03896.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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