Conjunctival Melanocytic Nevi With Granular Cell Change

Area of Science:

• Ophthalmology
• Dermatopathology
• Oncology

Background:

• Granular cell change in melanocytic nevi is rare, with limited literature.
• Unfamiliarity with these lesions complicates diagnosis.
• Only 4 cases of granular cell change in melanocytic nevus are documented, with one in the conjunctiva.

Purpose of the Study:

• To define the clinical and histopathologic characteristics of conjunctival nevi exhibiting granular cell change.
• To improve diagnostic accuracy for this rare conjunctival lesion.

Main Methods:

• Retrospective observational case series.
• Review of medical records for conjunctival nevi with granular cell change (December 2016 - October 2018).
• Data collection included demographics, clinical presentation, histopathology, and follow-up.

Main Results:

• Twelve patients (6 male, 6 female; median age 14) were identified.
• Lesions presented as pigmented nodules or patches, often on the bulbar conjunctiva or in the plica/caruncle, with frequent cysts.
• Histopathology revealed conventional nevi with granular cell change, positive for Melan-A, SOX10, and HMB-45, with a low Ki-67 index (<2%).

Conclusions:

• Granular cell change in conjunctival melanocytic nevi is underrecognized and can mimic melanoma.
• Diagnostic clues include young age, bulbar location, cysts, and absence of mitotic figures.
• No recurrences were observed in lesions with follow-up.