Cellular blue nevus of the uterus: a case report and review of the literature.

Cellular blue nevus is extremely rare in the gynecologic tract with only 2 cases reported thus far, one in the myometrium and the other in the cervix/vagina/hymenal ring. In this report, we present the clinicopathologic features of the second case of cellular blue nevus arising in the myometrium. The patient was a 48-year-old woman who underwent a hysterectomy with bilateral salpingo-oophorectomy for uterine leiomyomas. On gross examination, the uterus showed a subserosal, 1.0×0.5×0.3 cm, dark red nodule in the anterior uterine wall in addition to multiple leiomyomas. Microscopically, the subserosal dark nodule had an irregular contour with only focal areas of pushing circumscribed border. The tumor cells were arranged either in sheets or confluent nests. The tumor cells were mostly epithelioid with clear cytoplasm, but in some areas the tumor cells were spindle-shaped with eosinophilic cytoplasm. Both types of cells contained intracytoplasmic melanin. The nuclei of the tumor cells were either oval, round, or elongated with no or minimal irregularities of the nuclear membrane, evenly distributed chromatin, inconspicuous nucleoli, and no obvious mitotic figures. Focally some of the epithelioid cells showed enlargement of the nucleus, irregularities in the nuclear contour, and rare nuclear pseudoinclusions. The tumor cells were positive for S-100, HMB-45 antigen (strong and diffuse pattern), and MART-1. Anti-Ki-67 showed a low proliferative activity (only a rare cell marked for this immunomarker). Thus, a diagnosis of cellular blue nevus was established. After a follow-up of 2 months, the patient had no evidence of the disease.

Alcohol exposure on postnatal day 5 induces Purkinje cell loss and evidence of Purkinje cell degradation in lobule I of rat cerebellum.

The reduction in neuron number in specific brain regions is one of the most destructive aspects of alcohol-induced developmental brain injury, and its occurrence depends on the timing, pattern, and dose of maternal alcohol consumption during pregnancy. The purpose of this investigation was to quantify the dose-response aspect of Purkinje cell loss and rapid cellular degradation indicative of Purkinje cell loss following a single alcohol exposure on postnatal day 5 in lobule I, a lobule that has been shown to be vulnerable to alcohol-induced injury during cerebellar development. Fluoro-Jade B was used to identify Purkinje cell degeneration in 2-h intervals during the first 24h following the single alcohol exposure. At the end of 24h, stereology cell counting techniques were used to estimate the number of Purkinje cells in lobule I of the cerebellum. Significant Fluoro-Jade B labeling of lobule I Purkinje cells began at 12-h postexposure in the 6.0-g/kg group with continued significant expression of the marker at the 16- and 18-h time points. Notably, the magnitude of Fluoro-Jade B expression in the 6.0-g/kg group remained high during the period between 12 and 24h even though the difference between the 6.0-g/kg group and other groups did not reach statistical significance at the 14-, 20-, and 24-h time points. On postnatal day 6, 24h following the alcohol exposure, rats exposed to the highest alcohol dose (6.0 g/kg) had lost significantly more Purkinje cells than those in the nutritional or caloric control to the highest dose of alcohol group. These results are suggestive of a unique relationship among the quantity of alcohol, the onset and duration of cell degradation, and the degree of eventual cell loss. Given that cerebellar Purkinje cells (and many developing neurons) are vulnerable to alcohol-induced neuronal loss within hours of a single alcohol insult, women should be counseled to avoid drinking alcohol in a manner that significantly increases blood alcohol levels during pregnancy (e.g., binge drinking).