Case Study: December 2012


  • 60 year old female
  • 20 year history of black nodule lower lid
  • No change
  • Excised


  1. What are the main histological features?
  2. What is the differential?
  3. What’s the likeliest diagnosis?
  4. What are the associations?
Click to show answers
  1. Well defined, melanotic lesions, composed of epithelioid to spindle melanocytes, in fibrotic stroma with melanophages and dendritic melanised melanocytes. No mitotic activity, no necrosis
  2. Cellular blue naevus, deep penetrating naevus, metastatic melanoma to skin mimicking a blue naevus
  3. Cellular blue naevus
  4. Carney complex


  • Cellular blue nevi of the eyelid: A possible diagnostic pitfall. Wang Q, Prieto V, Esmaeli B, Kolda T, Lazar A, Ivan D, Diwan AH. J Am Acad Dermatol. 2008 Feb;58(2):257-60.