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Large plaque-type blue nevus with subcutaneous cellular nodules.
K J Busam1, J M Woodruff, R A Erlandson
1Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
The American Journal of Surgical Pathology
|January 13, 2000
Summary
This study identifies a rare variant of blue nevus, termed large plaque-type blue nevus with subcutaneous cellular nodules, which can be mistaken for melanoma. Early recognition is key to avoiding misdiagnosis of these benign melanocytic tumors.
Area of Science:
- Dermatology
- Pathology
- Oncology
Background:
- Atypical melanocytic nevi pose diagnostic challenges, often mimicking malignant melanoma.
- Distinguishing benign nevi from melanoma is crucial for appropriate patient management.
Observation:
- Two cases of an unusual blue nevus variant, presenting as large plaques with subcutaneous nodules, were initially misdiagnosed as malignancy.
- Clinical presentation included childhood onset, slow enlargement, and nodule formation in adolescence.
- Histopathology revealed multifocal proliferation of pigmented melanocytes with features ranging from dermal melanocytosis to cellular blue nevus in the subcutis.
Findings:
- Immunohistochemistry confirmed melanocytic origin (S-100, gp100, Melan-A).
- Ultrastructural analysis supported a blue nevus diagnosis.
- Patients showed no recurrence or progression after surgical excision, indicating a benign nature.
Implications:
- The identification of large plaque-type blue nevus with subcutaneous cellular nodules expands the understanding of melanocytic tumor morphology.
- Awareness of this variant aids in preventing misdiagnosis and unnecessary aggressive treatment for melanoma.
- This finding contributes to the accurate classification of melanocytic lesions.