| Mitotically active proliferative nodule arising in a giant congenital melanocytic nevus: a diagnostic pitfall. | |
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MedLine Citation:
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PMID: 23348144 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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ABSTRACT:: Proliferative (cellular) nodules (PN) which mimic malignant melanoma clinically and histologically are described in congenital melanocytic nevi (CMN) and may pose significant diagnostic challenges. We report the case of a 10-day-old male with a giant congenital nevus involving the neck, upper chest, back, and left shoulder containing several nodular lesions, some crusted. Biopsy of a nodule revealed densely packed nevus cells with hyperchromatic round to oval and occasionally irregularly shaped nuclei. There was no necrosis or pushing border, and the nodule blended with the adjacent nevus; however, the lesion demonstrated a significant number of mitoses (27 per mm) and a 60% labeling index with Ki-67. Further analysis by fluorescence in situ hybridization (FISH) with a 4-color probe set targeting 6p25, 6q23, 11q13, and centromere 6 revealed increased chromosomal copy numbers of all 4 probes, which was interpreted as evidence of polyploidy. In addition, analysis of DNA copy number changes using a single nucleotide polymorphism microarray (Affymetrix, Santa Clara, CA) showed no chromosomal aberrations. The diagnosis of PN in a giant congenital nevus was eventually rendered. At 13-month follow-up, the nodules showed no evidence of growth. Our case illustrates that PNs in the neonatal period might demonstrate extreme mitotic activity. This feature is worrisome when encountered in melanocytic lesions; however, it should not trigger by itself a diagnosis of melanoma in the absence of other histologic criteria of malignancy. In addition, we document polyploidy by FISH in PN, which can potentially be misinterpreted as a FISH-positive result. |
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Authors:
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Thuy L T Nguyen; Amy Theos; David R Kelly; Klaus Busam; Aleodor A Andea |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American Journal of dermatopathology Volume: 35 ISSN: 1533-0311 ISO Abbreviation: Am J Dermatopathol Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-01-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7911005 Medline TA: Am J Dermatopathol Country: United States |
Other Details:
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Languages: eng Pagination: e16-21 Citation Subset: IM |
Affiliation:
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*Department of Pathology, University of Alabama at Birmingham, Birmingham, AL †Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL ‡Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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