28. Malignant blue nevus

 
Quotation from the 9th edition of Lever's:
 
"It may arise in a blue or cellular blue nevus, a giant congenital nevus, or in a nevus of Ota, or it may be malignant from the start."
 
"Recognition of the lesion as a malignant blue nevus rather than a common melanoma is based on the absence of junctional activity and the presence of at least some bipolar tumor cells with branching dendritic processes containing melanin granules."
 
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA): None.
 
Statements contrary by ABA:
 
"Because the diagnoses "atypical blue nevus," "atypical cellular blue nevus," "metastasizing blue nevus" and "malignant blue nevus" have never been defined in a comprehensible, meaningful, repeatable way, they serve only to bewilder clinicians and, therefore, cannot be beneficial to patients. Most examples of "atypical blue nevus" and "atypical cellular blue nevus" reported on are not nevi at all, but are melanomas; they metastasized, some of them resulting in death.X The diagnoses "atypical blue nevus," "malignant blue nevus," and "metastasizing blue nevus" seem to denote, no matter how bizarrely, benignancy, the last word of each triplet being "nevus"; no nevus, including blue nevus, is malignant and none can metastasize. A nevus that metastasizes is a melanoma that was misdiagnosed originally. Moreover, the idea that "these lesions have the ability to metastasize to local lymph nodes but are not capable of widespread metastases" is distilled nonsense, contrary to logic, and an affront to rationality; a metastasis by definition, disseminates."
 
Mones JM, Ackerman AB. A critique in historical perspective of three concepts flawed fatally: "atypical" blue nevus, "malignant" blue nevus, and "metastasizing" blue nevus. Dermatopathology: Practical & Conceptual 10(1), 2004.
 
Other works of ABA in which the ideas contrary are expressed:
 
Ackerman AB, Cerroni L, Kerl H. Pitfalls in Histopathologic Diagnosis of Malignant Melanoma. Philadelphia: Lea & Febiger, 1994.