Contributor: Gordon K. Klintworth
Nevocellular nevi [nevus - nevocellular] of the conjunctiva are common and they are classified according to their location. These nevi may involve the subepithelial tissues [nevus - subepithelial], the subepithelium and epithelium [nevus - compound], or the base of the epithelium [nevus - junctional]. Junctional nevi of the conjunctiva most commonly present in children. They are frequently pigmented, but not necessarily so. In contrast to their counterpart in the skin, compound and subepithelial nevi of the conjunctiva are often associated with a substantial infiltrate of lymphocytes in the conjunctival stroma. Conjunctival compound and subepithelial nevi typically contain inclusion cysts [cyst - inclusion] or solid nests of surface conjunctival epithelium. Occasionally, these epithelial cysts enlarge leading to the clinical suspicion of a conjunctival malignant neoplasm. After being excised the epithelial hyperplasia should not be confused with invasive squamous cell carcinoma [carcinoma - squamous cell], but sometimes it has been. The most commonly excised melanocytic lesion of the conjunctiva is the compound nevocellular nevus. It is found most often in adolescents and young adults. An increase in pigmentation or size during puberty or pregnancy often prompts excision. Unlike nevi of the skin a substantial mononuclear inflammatory infiltrate is often present. Junctional nevi are rare and are almost always found in children.