Skin melanocytic tumor
Blue nevi, pigmented epithelioid melanocytomas and dermal melanocytoses
Cellular blue nevus


Topic Completed: 1 August 2014

Minor changes: 2 April 2020

Copyright: 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: cellular blue nevus

Christopher S. Hale, M.D.
Page views in 2019: 5,967
Page views in 2020 to date: 2,215
Cite this page: Hale CS. Cellular blue nevus. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumormelanocyticbluenevuscellular.html. Accessed May 26th, 2020.
Definition / general
  • Usually pigmented, biphasic tumor with component of classic blue nevus and distinct cellular areas composed of spindled to oval melanocytes with clear or finely-pigmented cytoplasm (Arch Pathol Lab Med 2011;135:327)
Epidemiology
Sites
  • Buttock and sacrococcygeal areas are most common
  • Also scalp, face, dorsal hands and feet
Clinical features
  • Amelanotic tumors have atypical clinical appearance
  • Large (> 1.5 cm) with intense pigmentation
Case reports
Treatment
  • Excision
Clinical images

Contributed by Mark R. Wick M.D.
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Cellular blue nevus (breast skin)



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Infiltrative giant cellular blue nevus

Microscopic (histologic) description
  • Well-circumscribed collection of interweaving fascicles with increased cellularity and extension into subcutis
  • Heavily pigmented spindle cells alternate with clear cells
  • Have pushing margins and variable fasciculation and neural structures
  • No / minimal atypia; no junctional activity, no epidermal invasion, no peripheral inflammation, no necrosis and no / rare mitotic figures
  • Scalp lesions may have intracranial extension
  • “Ancient” blue nevi show stromal changes of large dilated vessels with pseudoangiomatous features, hyaline angiopathy, myxoid changes, sclerosis or hyalinization of stroma and variable edema, similar to ancient melanocytic nevi (Am J Dermatopathol 2008;30:1)
  • Variants include amelanotic (Am J Surg Pathol 2002;26:1493) or with balloon cell change
  • Note: benign cellular blue nevi may involve lymph node parenchyma and sinuses in a metastatic-like pattern; as a result, some tumors are best classified as having “uncertain biologic behavior”
Microscopic (histologic) images

Contributed by Mark R. Wick M.D.
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Cellular type, breast



Case of the Month #7
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Low / medium power


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High power



Contributed by Angel Fernandez-Flores, M.D., Ph.D., Hospital El Bierzo and Clinica Ponferrada, Spain
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Various images



Images hosted on other servers:
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Infiltrative giant cellular blue nevus

Positive stains
Negative stains
Molecular / cytogenetics description
Videos

Differential diagnosis
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