[P190] Epithelioid blue nevus : a rare variant of blue nevus

( Seung Hwi Kwon ),( Ge-o Han ),( Hae Jun Song ),( Chil Hwan Oh ),( Jiehyun Jeon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

A 33-year-old male patient visited our clinic with black colored lightly depressed macule with indurated border on back. He had no underlying disease except chronic hepatitis B. He had received laser treatment but the nevus came back. Clinical impression was blue nevus and the lesion was excised. Histopathological findings showed a relatively well circumscribed, round tumor composed ofheavily pigmented, epithelioid melanocytes, intermixed with dendritic spindled and fusiform shaped melanocytes. Also, immunohistochemical findings included pigmented epithelioid cells positive for S-100 protein and HMB-45, consistent with epithelioid blue cell nevus. Blue nevus is a tumor of dermal dendritic melanocytic origin, and common blue nevus and cellular blue nevus are the most common variants. Epithelioid blue nevus (EBN) is another variant of blue nevus that arises in the background of Carney complex (myxomas, spotty skin pigmentation, endocrine overactivity and psammomatous melanotic schwannomas) or may occur sporadically. The major component of EBN is variably pigmented, epithelioid melanocytes with a few melanophages and only a few dendritic melanocytes. EBN is a diagnostically challenging entity because of its rarity and histological overlap with other pigmented melanocytic lesions, such as cellular blue nevus, malignant blue nevus, and malignant melanoma. Herein, we present a case of epithelioid blue nevus.

[P178] Plaque-type blue nevus in a Korean woman

( Hyun-bin Kwak ),( Sang-woo Park ),( Su-kyung Park ),( Soo-han Woo ),( Jin Park ),( Seok-kweon Yun ),( Han-uk Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Plaque-type blue nevus is a rare variant of blue nevus, the precise prognostic significance of which is unknown. We report the unusual and rare case of an uncommon large, agminated blue nevus of the ``plaque type`` in a 23-year-old Korean female. She presented with a large blue plaque, 2.5 x 6cm in size, on the right lower flank. There were spots of various shades of blue on the plaque. The lesion had developed since birth and became more prominent over the past years. The patient had noticed subcutaneous nodules recently. On physical examination, subcutaneous nodules were found on palpation with no pain. No enlargement of the regional lymph nodules was found. Upon dermoscopic examination, the lesion was typified by areas of homogenous, unstructured blue pigmentation, brownish-blue in the center and blue at the periphery. At the periphery, tan pigmentation was noted. A biopsy was taken from the lesions. Elongated melanocytes in the interstices of the collagen with some melanophages were typical of a common blue nevus. No malignant features were found. A diagnosis of plaque-type blue nevus was made.

Metastatic Blue Nevus-Like Melanoma Detected by Liquid-Based Catheterized Urine Cytology

( Sue Kyung Kim ),( Ji Young Yang ),( Jae Ho Han ),( Ji Eun Kwon ) 대한피부과학회 2018 Annals of Dermatology Vol.30 No.3

Primary or metastatic malignant melanoma can mimic benign blue nevus in rare cases, making the diagnosis challenging. Herein, we report an exceptionally rare case of blue nevus-like melanoma and its blue nevus-like metastasis which was detected by catheterized urine cytology. The patient presented with blue-colored papuloplaques on his temple which were diagnosed as blue nevus-like melanoma on punch biopsies. While he was admitted for administration of chemotherapy, hematuria was detected. Catheterized urine cytology revealed singly scattered oval to spindle-shaped pigmented cells with a moderate degree of variation in shape and size. Many of them had small nuclei with indiscernible to inconspicuous nucleoli while only a few cells showed nuclear enlargement and nuclear hyperchromasia, which could be diagnostic pitfalls. Most of the cells on the smear were positive for HMB45 immunostaining, which confirmed the diagnosis of metastatic blue nevus-like melanoma. To the best of our knowledge, the present case is the first report describing cytomorphologic findings of blue nevus-like metastasis of melanoma in the urine specimen. (Ann Dermatol 30(3) 356∼360, 2018)

Rapidly progressive malignant blue nevus

( Ji Young Yang ),( Sue Kyung Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Malignant blue nevus (MBN) is defined either as a fullymalignant neoplasm arising from blue nevus or a malignant neoplasm with the presence of typical blue nevus cells. Its natural history and prognosis are poorly understood. Herein, we report a case of a rapidly progressing MBN leading to expiration 3 months after diagnosis. A 61-year male presented with a blue-colored large solitary nodule with multiple satellite papules on the left temple with the duration of more than a year, which had been growing in size rapidly for 2 months. On skin biopsy, epithelioid and occasional spindle-like cells with minimal junctional activity, cellular atypia, and mitotic activity were seen. HMB45, MART-1 and Ki-67 were positive on immunohistochemical stain. Positron emission tomography revealed multiple lymph node and bone metastasis. After a month, while treated with dacarbazine, urine cytology of the patient showed HMB45 and MART-1 positive tumor cells, and his esophagogastroduodenoscopy biopsy results showed multiple metastases to tongue, throat and gastrointestinal tract from esophagus to duodenum. Two months later, the patient expired on account of pneumonia. Dermatologists should be aware that this rare, life-threatening malignancy can grow on the basis of blue nevus.

A Case of Benign Blue Nevus Located in Middle Ear Mucosa

조재만,백무진 대한이비인후과학회 부산,울산,경남 지부회 2018 임상이비인후과 Vol.29 No.1

A blue nevus, characterized by the proliferation of dermal dendritic melanocytes, usually appears as a solitary, small, asymptomatic blue-to-blue-black macule or papule on the dorsal aspect of the extremities, scalp, or buttocks. Blue nevi have also been reported in several extracutaneous sites, including the vagina; prostate; and intraoral, sinonasal, and colorectal mucosae. A 38-year-old female presenting with intermittent dizziness had a blue-black mass in the left middle ear, behind an intact tympanic membrane; the mass was evident on otoendoscopic examination. The mass was surgically removed and identified histologically as a benign blue nevus. To date, two cases of blue nevi in the middle ear have been reported. Here, we describe another such rare case.

Unexpected 18F-FDG uptake on PET/CT in benign cellular blue nevus

( Hyun Ji Lee ),( Seok Min Kim ),( Yong Hyun Jang ),( Weon Ju Lee ),( Seok-jong Lee ),( Jun Young Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

A 31-year-old female visited our department by consultation from department of breast surgery, because of unexpected high uptake of Fluorine-18 fluorodeoxyglucose (18F-FDG) in left buttock on PET/CT. It was conducted for staging her right breast cancer and axillary lymph node metastasis. Cutaneous examination showed a child fist sized blue to gray colored mass on her left buttock. But she didn’t remember its noticeable change since birth. Immediate tissue confirmation was done and revealed it as a benign blue nevus. Because she was on need of prompt treatment for breast cancer, surgical excision was performed 1 year later. Totally excised specimen was evaluated again for possible malignant change of cellular blue nevus. There were almost absent or rare cellular atypia and mitosis, and immunohistochemical stains (focal positive of HMB45, S-100, Melan-A and negative of Ki-67) didn’t reveal evidence to suspect melanoma or other malignancies. Therefore, we finally diagnosed it as benign cellular blue nevus. PET/CT imaging is usually performed to detect known or suspected malignancies and distant metastasis. But a variety of benign lesions with increased metabolic activity, such as inflammatory or infectious cutaneous conditions are observed as false positive FDG uptake. In this case, proliferation of pigmented spindle cells and its hypercellularity rather than malignant change or metastasis might have increased glucose metabolism.

Malignant melanoma associated with a plaque-type blue nevus of the cheek: a case report

Yoon Kyu Chung,Min-Seok Kim,Jin Yong Shin,이내호,Ae Ri An,노시균 대한두개안면성형외과학회 2023 Archives of Craniofacial Surgery Vol.24 No.2

Blue nevi, which are characterized by collections of pigment-producing melanocytes in the dermis, have a variety of clinicopathological characteristics. Plaque-type blue nevus (PTBN) is a variant of blue nevi. PTBN presents at birth or arises in early childhood, and it shows a combination of the features found in common blue nevus and cellular blue nevus. It is typically found on the dorsal surface of the hands and feet or on the head and neck, and it is usually benign and stable over time. However, reports have occasionally described malignant melanomas developing in or associated with a PTBN. Malignant blue nevi are most commonly found on the scalp. We report the case of an 88-year-old woman with a malignant melanoma associated with a PTBN of the cheek.

아랫입술에 발생한 상피양 청색 모반

서동우 ( Dong Woo Suh ),유박린 ( Bark Lynn Lew ),심우영 ( Woo Young Sim ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.9

Epithelioid blue nevus is a rare variant of blue nevus that has been recently described in patients with the Carney complex. However, sporadic cases have been reported even without the Carney complex. It typically presents as an asymptomatic, blue-gray, smooth-surfaced macule or papule occurring most often on the extremities and trunk. However, a few cases occurring on the mucosa have been reported. A 21-year-old man presented with a 0.4-cm sized solitary dark brownish or black papule on the lower lip. On histological examination, the major part of the specimen showed an infiltration of intensely pigmented epithelioid cells, the rest was composed of mildly pigmented spindle cells. There was no junctional activity, necrosis, or cellular atypia. These findings were consistent with epithelioid blue nevus. The patient did not exhibit any features associated with the Carney complex. No evidence of recurrence was observed during the follow-up period of 24 months. Herein, we report a rare case of epithelioid blue nevus arising on an unusual site. (Korean J Dermatol 2014;52(9):658∼661)

세포성 청색모반 1예

명나혜,지제근,조병규,송계용 대한병리학회 1993 Journal of Pathology and Translational Medicine Vol.27 No.5

[P424] Epithelioid blue nevus: Dermoscopic features

( Myeong Hyeon Yang ),( Ji Yun Jang ),( Joon Hee Kim ),( Hyun Hwangbo ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Epithelioid blue nevus (EBN) is a rare but distinctive histologic variant of blue nevus that has been described in patients with Carney complex, an autosomal-dominant multiple neoplasia syndrome. Clinically, EBN is typically characterized as small (less than 1 cm), darkly pigmented, dome-shaped nodules or, less commonly, as macules on the skin or mucosa. Recently, cases of EBN have been reported in patients without Carney complex. On histologic findings, variably pigmented, large epithelioid melanocytes with vesicular nuclei and a small number of melanophages that are sometimes associated with a few pigmented, spindle, and dendritic cells can be seen. A 40-year-old male presented with a solitary steel bluish well demarcated 6 x 4 mm sized nodule with central umbilication on the left arm without any clinical evidence of Carney complex. On dermoscopy, oval shaped, diffuse structureless area with steel-blue pigmentation and a central round dimple with whitish rim were seen. In the absence of any other dermoscopic structures, a clinical diagnosis of blue nevus was established. Histologic findings showed a wedge shaped symmetrical structure composed of heavily pigmented cells involving the dermis. On higher magnification, epithelioid melanocytes with large cytoplasm and abundant melanin within their cytoplasm were seen. The diagnosis of EBN was made. Herein, we report a case of EBN for whom dermoscopy was used as a helpful diagnostic tool.