(130) Although we do not advocate use of the oxymoronic term malignant
blue nevus in practice, we have used it here to encompass 2 separate entities: a de novo melanoma that adopts a blue nevus-like morphology (blue nevus-like melanoma) and a melanoma arising within a preexisting
blue nevus.
Blue nevus is a rare lesion of dermal melanocytes most commonly found in the skin, but it has been reported in the oral mucosa, sclera, cervix, vagina, and prostate [27].
Pathologic diagnosis: Benign tumors Diagnosis n (%) Hemangioma 5 (9) Ossifying fibroma 4 (7) Adnexal neoplasm 1 (2) Ameloblastic fibro-odontoma 1 (2) Benign fibrous histiocytoma 1 (2)
Blue nevus 1 (2) Compound nevus 1 (2) Epithelioma adenoides cysticum 1 (2) Giant cell granuloma 1 (2) Lymphangioma 1 (2) Neurofibroma 1 (2) Osteochondroma 1 (2) Port wine stain 1 (2) Spitz nevus 1 (2) Xanthogranuloma 1 (2) Total 22 (41) Table 4.
The number of hair follicles in NCH lesions are decreased, as mentioned above, but not in the
blue nevus. Immunostaining in our patient confirmed a melanocytic-nevic origin and the lesion was floridly positive for S100, MITF, Melan A, tyrosinase, CD34 and HMB45.
Epithelioid
blue nevus and psammomatous melanotic schwannoma: the unusual pigmented skin tumors of the Carney complex.
In the papillary and upper reticular dermis, dendritic melanocytes are present and surrounded by fibrous sheaths (which are not present in other dermal melanocytosis, such as
blue nevus or mongolian spots).
This syndrome is characterized by the following: nevus flammeus, nevus spilus, lentigines,
blue nevus with or without nevus amenicus.
(14,15) Additionally, HMB45 may not be as useful in blue nevus-related lesions and malignant
blue nevus cases.
B, Cellular
blue nevus, displaying bland, fusiform spindled cells without nuclear atypia or mitotic activity.
Several proof-of-principle studies showed potential applications of FISH to solve a variety of diagnostic dilemmas in the evaluation of melanocytic tumors, including differentiating blue nevus-like metastasis from
blue nevus, mitotically active nevus from nevoid melanoma, and dysplastic nevus from superficial spreading melanoma.
"Atypical"
blue nevus, "malignant"
blue nevus, and "metastasizing"
blue nevus: a critique in historical perspective of three concepts flawed fatally.