PMID- 23348144
OWN - NLM
STAT- MEDLINE
DCOM- 20130726
LR  - 20151119
IS  - 1533-0311 (Electronic)
IS  - 0193-1091 (Linking)
VI  - 35
IP  - 1
DP  - 2013 Feb
TI  - Mitotically active proliferative nodule arising in a giant congenital melanocytic 
      nevus: a diagnostic pitfall.
PG  - e16-21
LID - 10.1097/DAD.0b013e318265fe12 [doi]
AB  - 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 mm2) 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.
FAU - Nguyen, Thuy L T
AU  - Nguyen TL
AD  - Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 
      35294-0009, USA. tnguy9@uab.edu
FAU - Theos, Amy
AU  - Theos A
FAU - Kelly, David R
AU  - Kelly DR
FAU - Busam, Klaus
AU  - Busam K
FAU - Andea, Aleodor A
AU  - Andea AA
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Am J Dermatopathol
JT  - The American Journal of dermatopathology
JID - 7911005
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Ki-67 Antigen)
SB  - IM
MH  - Biomarkers, Tumor/analysis/genetics
MH  - Biopsy
MH  - *Cell Proliferation
MH  - Comparative Genomic Hybridization
MH  - DNA Copy Number Variations
MH  - Diagnosis, Differential
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Infant, Newborn
MH  - Ki-67 Antigen/analysis
MH  - Male
MH  - Melanoma/*pathology
MH  - *Mitosis
MH  - Nevus, Pigmented/chemistry/congenital/genetics/*pathology
MH  - Oligonucleotide Array Sequence Analysis
MH  - Polyploidy
MH  - Predictive Value of Tests
MH  - Skin Neoplasms/chemistry/congenital/genetics/*pathology
EDAT- 2013/01/26 06:00
MHDA- 2013/07/28 06:00
CRDT- 2013/01/26 06:00
PHST- 2013/01/26 06:00 [entrez]
PHST- 2013/01/26 06:00 [pubmed]
PHST- 2013/07/28 06:00 [medline]
AID - 00000372-201302000-00031 [pii]
AID - 10.1097/DAD.0b013e318265fe12 [doi]
PST - ppublish
SO  - Am J Dermatopathol. 2013 Feb;35(1):e16-21. doi: 10.1097/DAD.0b013e318265fe12.