Cases reported "Nevus, Blue"

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1/40. Metastatic melanoma to the skin simulating blue nevus.

    Cutaneous metastases from melanoma can mimic primary melanoma and melanocytic nevi. Recognition of a metastatic lesion is of great importance for proper staging and treatment decisions. In this study, a potential diagnostic pitfall is described and discussed: dermal metastases from cutaneous melanoma simulating blue nevus, a phenomenon that has received little attention. Ten blue nevus-like lesions from three patients are presented. All contained pigmented melanocytes and melanophages in variable proportions arranged in a blue nevus-like growth pattern. The blue nevus-like metastases occurred in the same anatomic region as the primary tumor or, as in one patient, near the skin scar of a dissected lymph node metastasis. Histologic clues of metastatic melanoma included the presence of atypical epithelioid melanocytes, mitotic figures, and an associated inflammatory cell infiltrate at the periphery of the lesion. Although such histologic features facilitate the recognition of a metastasis, clinical correlation is essential for a definitive diagnosis.
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ranking = 1
keywords = melanoma
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2/40. Balloon cell change in cellular blue nevus.

    Balloon cells are altered melanocytes with clear vacuolated cytoplasm caused by a defect in the process of melanogenesis. Although rare, balloon cell change has been observed in a variety of melanocytic proliferations, particularly intradermal melanocytic nevi and melanoma. When present, such features may lead to difficulties in diagnosis, particularly with other clear cell neoplasms. We report an unusual case of the development of balloon cell change in a cellular blue nevus, a phenomenon that has not been extensively addressed in the literature. The importance of recognizing this change in cellular blue nevus to avoid misinterpreting the lesion as malignant is discussed.
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ranking = 0.125
keywords = melanoma
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3/40. Conjunctival melanocytic nevi of childhood.

    Two young patients with conjunctival compound nevi are presented to illustrate two types of abnormalities that lead to difficulty in distinction of these nevi from invasive melanomas. In Case 1, inflammation is associated with disruption of the nevus cell architecture and cytologic atypia. In Case 2, the occurrence of a combined nevus (compound and blue nevus types) in the conjunctiva leads to diagnostic problems. Circumscription of the lesions, lack of mitoses in the substantia propria, and lack of pagetoid spread of atypical cells in the adjacent conjunctival epithelium support benign diagnoses in both cases.
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ranking = 0.125
keywords = melanoma
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4/40. Combined nevi of the conjunctiva.

    OBJECTIVE: To report the clinical and histologic features of combined nevi of the conjunctiva, a type of nevus that is not uncommon in the skin but rarely has been reported in the conjunctiva. methods: Conjunctival nevi and melanomas in the files of the University of california at san francisco eye pathology Laboratory from 1984 to 1999 were reviewed for the presence of features of both standard nevocytic nevi and blue nevi. Clinical histories and, when available, clinical photographs were obtained. RESULTS: Thirty combined nevi were discovered between 1984 and 1999. One case before 1984 had been incorrectly diagnosed as a junctional nevus. The dendritic and spindle-shaped blue nevus cells had been overlooked because they were not recognized as distinct from the standard nevocytic nevus cells. The recognition of blue as well as a brown color, a deep as well as a superficial component in the lesion, or a history of pigmentation since birth may help to establish the correct clinical diagnosis and prevent an unnecessarily deep surgical resection. Although growth of the lesion or "satellites" in some may favor a clinical diagnosis of melanoma, no lesions in this series were malignant. CONCLUSION: Despite a paucity of reports of combined nevi of the conjunctiva in the medical literature, this type of nevus, a combination of a nevocytic and a blue nevus, is common and has been overlooked in the past.
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ranking = 0.25
keywords = melanoma
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5/40. Common blue naevus with satellite lesions: possible perivascular dissemination resulting in a clinical resemblance to malignant melanoma.

    We report a case of common blue naevus with polymorphous guttate and linear satellite lesions, thereby mimicking peripherally spreading malignant melanoma. Histopathologic examination showed that the naevus cells are clustered around blood vessels in the primary as well as satellite lesions, suggestive of spreading of the naevus cells along the perivascular space. Such biological behaviour resulting in a clinical manifestation of a malignant melanoma-like lesion is a rarity in common blue naevus, a benign cutaneous disorder that is devoid of a malignant potential, and has not been described before.
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ranking = 1.2313989142839
keywords = melanoma, malignant melanoma
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6/40. Large plaque-type blue nevus with subcutaneous cellular nodules.

    Unusual or atypical melanocytic nevi can be confused with malignant melanoma. The authors present two cases of an unusual variant of blue nevus that were misdiagnosed initially as malignancy. Both lesions were asymptomatic and characterized clinically by childhood onset, with slow enlargement during adolescence and subsequent nodule formation. One lesion, which measured 24 cm in greatest dimension, was located on the anterior chest wall of a 53-year-old woman. The other lesion, which measured approximately 15 cm in greatest dimension, was located on the lateral abdominal wall of a 20-year-old man. Both lesions were characterized by a multifocal dermal and subcutaneous proliferation of fusiform and dendritic pigmented melanocytes. The histologic appearance of individual foci ranged from dermal melanocytosis to common blue nevus and cellular blue nevus. The cellular foci were located in the subcutis and involved, in one patient, the stroma of the breast. The cells were immunoreactive for S-100 protein, gp100 (HMB-45), and Melan-A (A103). Ultrastructural analysis revealed melanocytes typical of blue nevus. The woman underwent complete excision of the lesion, and the man underwent only partial excision of the lesion. On clinical follow-up of 32 and 19 months, respectively, both patients are alive and well with no evidence of recurrence or progression. Because the lesions presented clinically as large plaques and were diagnosed histologically as blue nevi with subcutaneous foci of cellular blue nevus, we term this rare variant of blue nevus large plaque-type blue nevus with subcutaneous cellular nodules. Recognition of this lesion enhances our knowledge of the morphologic spectrum of melanocytic tumors and helps to avoid confusion with malignant melanoma.
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ranking = 0.41046630476129
keywords = melanoma, malignant melanoma
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7/40. Multiple blue nevi of the vagina. A case report.

    BACKGROUND: Melanotic lesions of the vagina are very rare; clinically, most are suspected to be malignant melanomas. Occasional benign cases, however, require differential diagnostic consideration. We report a case of multiple (benign) blue nevi of the vagina. CASE: A 51-year-old woman presented with bluish black macules irregularly distributed throughout the vagina. Biopsies revealed pigmented cells in the dermis that proved to be melanocytes. The patient received no therapy. The lesions remained unchanged in the follow-up period. CONCLUSION: Multiple blue nevi could be a differential diagnosis for malignant melanoma of the vagina. Our patient showed no malignant transformation over a 29-year period. Therapy for blue nevi in the vagina does not require complete excision.
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ranking = 0.41046630476129
keywords = melanoma, malignant melanoma
(Clic here for more details about this article)

8/40. Combined nevi of the conjunctiva.

    PURPOSE: To report the clinical and histologic features of combined nevi of the conjunctiva, a type of nevus that is not uncommon in the skin but has rarely been reported in the conjunctiva. methods: Conjunctival nevi and melanomas from the files of the University of california, san francisco, eye pathology laboratory were reviewed from 1984 to 1999 for the presence of features of both standard nevocytic nevi and blue nevi. Clinical histories and, when available, clinical photographs were obtained. RESULTS: Thirty-one combined nevi were discovered during the 15-year period between 1984 and 1999. One case before 1984 had been incorrectly diagnosed as a junctional nevus. The dendritic and spindle-shaped blue nevus cells had been overlooked because they were not recognized as distinct from the standard nevocytic nevus cells. The recognition of a blue as well as a brown color, a deep as well as a superficial component in the lesion, or a history of pigmentation since birth may help to establish the correct clinical diagnosis and prevent an unnecessarily deep surgical resection. Although growth of the lesion or "satellites" in some patients may favor a clinical diagnosis of melanoma, none of the lesions in this series were malignant. CONCLUSION: Despite a paucity of reports of combined nevi of the conjunctiva in the medical literature, this type of nevus--a combination of a nevocytic and a blue nevus--is common and has been overlooked in the past.
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ranking = 0.25
keywords = melanoma
(Clic here for more details about this article)

9/40. Blue nevus with satellitosis mimicking malignant melanoma.

    Blue nevus rarely develops a malignant melanoma. The loss of the regular border and the development of satellite lesions are ominous clinical indicators of the malignant change. A case is presented in which both of these clinical features--irregular border and satellite lesions--were present, but no malignant change was observed histopathologically. To our knowledge, such a single nodule with satellite lesions mimicking malignant melanoma has not been described previously.
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ranking = 1.2313989142839
keywords = melanoma, malignant melanoma
(Clic here for more details about this article)

10/40. Giant cellular blue nevus of the anterior chest wall mimicking metastatic melanoma to the breast: a case report.

    BACKGROUND AND OBJECTIVES: Blue nevi are benign pigmented dermal lesions that can mimic cutaneous melanoma in appearance. Cellular components may infiltrate subcutaneous tissue. We present a complex case of cellular blue nevus (CBN) to demonstrate the ambiguous clinical appearance of these lesions and to provide an approach for management of such cases. methods: We report an extraordinary case of CBN mimicking metastatic melanoma to the breast. A 53-year-old female with an acquired giant blue nevus of the chest wall was found to have two new breast nodules suspicious for malignancy on routine mammography. These were biopsied and interpreted as consistent with metastatic melanoma vs. CBN. The patient underwent complete excision of the chest wall nevus and modified radical mastectomy. RESULTS: Pathologic evaluation of the chest wall specimen revealed numerous collections of deeply pigmented melanocytes scattered throughout the breast parenchyma and embracing ductal structures. No mitoses or nuclear polymorphism were seen. The diagnosis of CBN involving the chest, breast tissue and axillary lymph nodes was made. CONCLUSION: Giant blue nevi overlying the breast can develop cellular components that infiltrate subcutaneous and breast tissue resulting in the appearance of breast nodules on mammography. A generous excision biopsy inclusive of the overlying nevus and breast component may be required to establish the dignity of the lesion.
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ranking = 0.875
keywords = melanoma
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