Inflamed Conjunctival Nevi: Histopathological Criteria

Abstract

Inflamed conjunctival nevi (ICN) may suggest malignancy because of their rapid growth and atypical histology. The objective of this study was to characterize the diagnostic features of ICN. A retrospective, nonrandomized study of 13 patients with ICN was conducted. A scoring method was developed based on histology and immunopathological parameters. The presence of epithelial solid or cystic inclusions and the preservation of goblet cells are consistent with a benign melanocytic lesion. Periodic acid–Schiff stain and immunohistochemistry to identify the epithelial component prove helpful in the differential diagnosis for melanoma. Polyclonal lymphoid infiltrate and benign cytological features of ICN exclude a diagnosis of lymphoma. Despite the presence of immunoglobulin 4–positive plasma cells in the lesions, ICN does not meet the diagnostic criteria for immunoglobulin 4–related disease. Most patients with ICN are young. The treatment for ICN is complete excision, and the prognosis is excellent.