Incident light microscopy, blue-in-pink zone

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

blue-in-pink area; blue-red area

Definition
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Oval or polygonal areas of about 0.2-0.4 mm in size, rarely more than 1.0 mm in size, with bluish streaky pigment densifications projected into the incident light plane against a pink background.

General information
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Incident light microscopy: In the centre or border of the lesion there are usually circumscribed oval or polygonal areas with bluish stripes or agglomerates (melanophagus accumulations) against a pink background (neovascularization). In some cases the lateral edges of the stripes show small serrations. Bluish pigment densities are loosely aggregated like dots.

Occurrence
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Within the group of pigment cell tumors, malignant melanomas have a specificity of over 80% (sensitivity 36%) for the blue-in-pink zone phenomenon under the reflected light microscope. More rarely, such changes are found in dysplastic nevi, combined nevi, recurrent nevi, pointed nevi or basal cell carcinomas.

Histology
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Melanophages and/or infiltrating tumor cell strands are located within capillary vascularized, neovascularized fibrosis zones. The reteleistes are completely destroyed in this region.

Literature
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  1. Schulz H (1994) Malignant melanomas in reflected light microscopy. dermatologist 45: 15-19
  2. Proud W, Braun-Falco O, Bilek P, Landthaler M, Burgdorf WHC, Cognetta AB (2002) Color atlas of dermatoscopy. Blackwell, Berlin Vienna

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Last updated on: 29.10.2020