PMC5726692_01
Irregular, asymmetric pigmented lesion on the left nasal root
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PMC5726692_01_abd-92-05-s1-0101-g01.jpg
f1
Examination revealed an ill-defined 15 mm x 7 mm macule with an irregular shape and asymmetrical distribution of the pigment network (Figure 1).
A: Hematoxylin & eosin staining of melanoma in
situ with follicular involvement and syringoma structures
in the middle dermis (X2). B: Detail of the collision
between the melanoma in situ and the syringoma (X200)
abd-92-05-s1-0101-g02.jpg
PMC5726692_01_abd-92-05-s1-0101-g02.jpg
f2
In the upper and middle dermis there were clusters of small ducts, occasionally with comma-shaped extensions, lined by a double-layered epithelium typical of a syringoma (Figure 2).
A: Melan-A staining showing the melanoma in
situ with follicular involvement (x200). Duct structures do
not stain. B: CEA staining showing the ducts of the
syringoma (X100)
abd-92-05-s1-0101-g03.jpg
PMC5726692_01_abd-92-05-s1-0101-g03.jpg
f3
Immunohistochemical staining confirmed that melanoma was positive for Melan-A and HMB45 and that syringoma was positive for the carcinoembryonic antigen (CEA) (Figure 3).