Purpose

Blue nevus is a melanocytic tumor that is commonly found in the skin. Extracutaneous presentations, including the ocular surface, are rare. As such, the purpose of this study was to characterize the clinical features and clinical course of congenital melanocytic tumor (blue nevus) of the conjunctiva.

Design

Retrospective, noncomparative case series.

Participants

Twenty-one patients with 23 blue nevi of the ocular surface that were excised surgically between 2000 and 2016.

Methods

Chart review of patients identified from a database search of the Florida Lions Ocular Pathology Laboratory records. Pathologic diagnoses were confirmed by 2 pathologists (S.R.D. and G.E.). All specimens were bleached and, tissue permitting, stained using SOX10 (MilliporeSigma, Darmstadt, Germany) and CD68 (Leica Biosystems, Nussloch, Germany).

Main Outcome Measures

Clinical characteristics, pathologic features, and clinical course.

Results

Mean age of the population was 55±15 years; 71.4% (n = 15) were white and 57.1% (n = 12) were men. One patient had 3 lesions, for a total of 23 lesions examined. Clinically, 13 lesions were on the bulbar conjunctiva, 3 were on the tarsal conjunctiva, 3 were in the fornix, 2 were caruncular, 1 was episcleral, and 1 was at the limbus. Before excision, 8 patients were thought to have primary acquired melanosis, 4 with concern for primary conjunctival melanoma, and 1 thought to have metastatic disease from a plantar melanoma. Five lesions were thought to be benign, and in 8 patients, the lesions were identified incidentally after other ocular surgeries, with no diagnosis of the lesions before excision. Pathologic features were consistent with simple blue nevi in 21 lesions and cellular blue nevus in 2 lesions. No malignant transformations were noted in any patient over the mean 20.2-month follow-up period (range, 2 weeks–103 months).

Conclusions

Blue nevus is a rare deeply pigmented congenital melanocytic lesion with a benign clinical course that can appear clinically similar to primary acquired melanosis or melanoma.

中文翻译：

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眼表的蓝色痣

目的

蓝色痣是一种黑素细胞瘤，通常在皮肤中发现。包括眼表在内的皮外表现很少见。因此，本研究的目的是表征结膜的先天性黑素细胞瘤（蓝色痣）的临床特征和临床过程。

设计

回顾性，非比较性案例系列。

参加者

2000年至2016年之间通过手术切除了21例眼表面蓝色痣23例。

方法

通过对佛罗里达狮子眼病理实验室记录的数据库搜索确定的患者病历图。两名病理学家（SRD和GE）确认了病理诊断。将所有样品漂白，并在组织允许的情况下，使用SOX10（MilliporeSigma，达姆施塔特，德国）和CD68（Leica Biosystems，Nussloch，德国）进行染色。

主要观察指标

临床特征，病理特征和临床过程。

结果

人口平均年龄为55±15岁；白人为71.4％（n = 15），男性为57.1％（n = 12）。一名患者有3个病变，总共检查了23个病变。临床上，在球结膜上有13个病灶，在结膜上有3个病灶，在穹lesions中有3个病灶，在房室结2个，巩膜巩膜1个，在角膜缘1个。切除前，认为8例原发性黑色素沉着病，4例关注原发性结膜黑色素瘤和1例因from底黑色素瘤转移性疾病。五个病变被认为是良性的，并且在8例患者中，在其他眼科手术后偶然发现了这些病变，而在切除前并未对这些病变进行诊断。病理特征与21个病变中的单纯蓝色痣和2个病变中的细胞蓝色痣一致。

结论

蓝色痣是一种罕见的色素沉着的先天性黑素细胞病变，具有良好的临床病程，在临床上可能看起来与原发性获得性黑素病或黑色素瘤相似。