TY - JOUR
T1 - Blue nevi of the Müllerian tract
T2 - Case series and review of the literature
AU - Craddock, Kenneth J.
AU - Bandarchi, Bizhan
AU - Khalifa, Mahmoud A.
PY - 2007/10/1
Y1 - 2007/10/1
N2 - BACKGROUND. Blue nevi are rare in the cervix and vagina. Melanocytes are not normally found in these sites and have been hypothesized to arise either from the Schwann cells of stromal nerves or from melanocytic precursors which have aberrantly migrated from the neural crest to rest in the Müllerian stroma. Because of their rarity (3 previous cases in the literature), vaginal blue nevi have not previously been studied with immunohistochemical and ultrastructural analysis. DESIGN. We describe 3 cases of blue nevus occurring in the Müllerian tract, 1 in the vagina and 2 in the endocervix. RESULTS. The vaginal lesion was seen during routine examination of a 40-year-old woman. The endocervical blue nevi were incidental findings in hysterectomies performed for leiomyomata and endometrial serous carcinoma in women aged 44 and 57 years, respectively. All 3 cases showed loose aggregates of cytologically benign, pigmented, dendritic spindle cells in the superficial stroma. They were immunoreactive for S100 and melan-A, but not HMB45. Ultrastructural analysis revealed numerous melanosomes, with no Schwannian features identified. Compared with the endocervical lesions, the vaginal nevus cells were more heavily pigmented, and on electron microscopy, a greater proportion of stage IV melanosomes were seen. CONCLUSIONS. We provide the first immunohistochemical and ultrastructural findings in a vaginal blue nevus, which confirm that it is of a similar nature to the endocervical blue nevi. Ultrastructurally, our results support a melanocytic rather than Schwannian origin for Müllerian blue nevi.
AB - BACKGROUND. Blue nevi are rare in the cervix and vagina. Melanocytes are not normally found in these sites and have been hypothesized to arise either from the Schwann cells of stromal nerves or from melanocytic precursors which have aberrantly migrated from the neural crest to rest in the Müllerian stroma. Because of their rarity (3 previous cases in the literature), vaginal blue nevi have not previously been studied with immunohistochemical and ultrastructural analysis. DESIGN. We describe 3 cases of blue nevus occurring in the Müllerian tract, 1 in the vagina and 2 in the endocervix. RESULTS. The vaginal lesion was seen during routine examination of a 40-year-old woman. The endocervical blue nevi were incidental findings in hysterectomies performed for leiomyomata and endometrial serous carcinoma in women aged 44 and 57 years, respectively. All 3 cases showed loose aggregates of cytologically benign, pigmented, dendritic spindle cells in the superficial stroma. They were immunoreactive for S100 and melan-A, but not HMB45. Ultrastructural analysis revealed numerous melanosomes, with no Schwannian features identified. Compared with the endocervical lesions, the vaginal nevus cells were more heavily pigmented, and on electron microscopy, a greater proportion of stage IV melanosomes were seen. CONCLUSIONS. We provide the first immunohistochemical and ultrastructural findings in a vaginal blue nevus, which confirm that it is of a similar nature to the endocervical blue nevi. Ultrastructurally, our results support a melanocytic rather than Schwannian origin for Müllerian blue nevi.
KW - Blue
KW - Cervix uteri
KW - Nevus
KW - Vagina
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U2 - 10.1097/LGT.0b013e318046eaf3
DO - 10.1097/LGT.0b013e318046eaf3
M3 - Article
C2 - 17917577
AN - SCOPUS:34948841920
SN - 1089-2591
VL - 11
SP - 284
EP - 289
JO - Journal of lower genital tract disease
JF - Journal of lower genital tract disease
IS - 4
ER -