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Case Reports
. 2017 Jan-Feb;92(1):110-112.
doi: 10.1590/abd1806-4841.20174502.

Atypical cellular blue nevus or malignant blue nevus?

Luise Ribeiro Daltro  1 , Lygia Bertalha Yaegashi  2 , Rodrigo Abdalah Freitas  2 , Bruno de Carvalho Fantini  1 , Cacilda da Silva Souza  1
Affiliations
Case Reports

Atypical cellular blue nevus or malignant blue nevus?

Luise Ribeiro Daltro et al. An Bras Dermatol. 2017 Jan-Feb.

Abstract

Blue nevus is a benign melanocytic lesion whose most frequent variants are dendritic (common) blue nevus and cellular blue nevus. Atypical cellular blue nevus presents an intermediate histopathology between the typical and a rare variant of malignant blue nevus/melanoma arising in a cellular blue nevus. An 8-year-old child presented a pigmented lesion in the buttock since birth, but with progressive growth in the last two years. After surgical excision, histopathological examination revealed atypical cellular blue nevus. Presence of mitoses, ulceration, infiltration, cytological atypia or necrosis may occur in atypical cellular blue nevus, making it difficult to differentiate it from melanoma. The growth of blue nevus is unusual and considered of high-risk for malignancy, being an indicator for complete resection and periodic follow-up of these patients.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
A) Nodule with dark blue homogeneous pigmentation, symmetrical and regular borders, measuring 2.5 cm in diameter on gluteus; B) Dermoscopy exhibited a homogeneous and structureless pigment pattern of grayish-brown color, more evident in the follicular ostia
Figure 2
Figure 2
Melanocyte proliferation occupying papillar and reticular dermis, and forming nests; no alteration in the epidermis was observed (Hematoxylin & eosin x40)
Figure 3
Figure 3
Nests compose of heavily pigmented and dendritic melanocytes in the periphery; pale and ovoid melanocytes of intermediate size in the center were consistent with cellular blue nevus (Hematoxylin & eosin x100)
Figure 4
Figure 4
Pleomorphic and vesicular nuclei, evident nucleoli, and occasional mitosis (<2/mm2) were compatible with atypical cellular blue nevus (Hematoxylin & eosin x400)
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