Juvenile Conjunctival Nevus: Clinicopathologic Analysis of 33 CasesThiagalingam, Sureka MBChB, MPH* †; Johnson, Matthew M. MD† ‡; Colby, Kathryn A. MD, PhD* †; Zembowicz, Artur MD, PhD* † ‡The American Journal of Surgical Pathology: March 2008 - Volume 32 - Issue 3 - p 399-406 doi: 10.1097/PAS.0b013e31815143f3 Original Articles Buy SDC Abstract Author InformationAuthors Article MetricsMetrics Conjunctival nevi in children and adolescents often have histologic features that can be difficult to differentiate from malignancy. We have identified a subset of childhood nevi displaying a confluent growth pattern and a lack of maturation that we have defined as juvenile conjunctival nevi (JCN), with the aim of further describing the clinicopathologic features of these lesions. Lesions identified as conjunctival nevus in a tertiary referral hospital were reviewed and the subset of lesions identified as JCN were further evaluated. Clinical details including follow-up data were also gathered. Of the 40 conjunctival nevi identified, 33 fit the criteria for JCN. The mean age at time of excision was 10.9 years (range: 4 to 19 y). Thirty-two lesions were of the compound type; one was a junctional nevus. All showed a nested junctional growth pattern. In 17 lesions (61%), the junctional component extended beyond the subepithelial component (shoulder phenomenon). Maturation was absent in 21 of the compound nevi (66%, average age 10.3 y), and incomplete in the remaining 11 lesions (34%, average age 12.1 y). The nuclei of the subepithelial nevus cells were larger than the epithelial nevus cells in 19 nevi (59%) and the same size in 13 (41%). A lymphocytic host response was present in 17 lesions (52%). Mitotic figures were rarely seen. None of the lesions had recurred over an average follow-up period of 34 months. Recognition of JCN as a distinct morphologic variant of a conjunctival nevus with characteristic histologic features may help to distinguish this benign lesion from melanoma. *Department of Ophthalmology, Massachusetts Eye and Ear Infirmary †Harvard Medical School ‡Department of Pathology, Massachusetts General Hospital, Boston, MA Industry/Pharmaceutical Support: None. Reprints: Artur Zembowicz, MD, PhD, Department of Pathology, Lahey Clinic, Burlington, MA 01805 (e-mail: dr.z@DermatopathologyConsultations.com). © 2008 Lippincott Williams & Wilkins, Inc.