PMC3884181_01
The scar from a previously excised nevus located 4 cm below the metastatic inguinal lymphadenopathy.
cde-0005-0290-g01.jpg
PMC3884181_01_cde-0005-0290-g01.jpg
F1
A full skin evaluation did not reveal any suspicious lesions, but 4 cm below the metastatic lymph node, the scar from the previously removed nevus could be seen (fig. 1).
a At low power, nevoid melanoma has the architecture of a banal compound nevus (HE staining, x20). Diagnostic clues included. b The presence of dermal mitotic figures (5 mitoses/mm2) at high power (HE staining, x80). c A high Ki-67 immunoreactivity (Ki-67 index 20%) in the lower parts of the lesion (x80).
cde-0005-0290-g02.jpg
PMC3884181_01_cde-0005-0290-g02.jpg
F2
The histopathologic slides of the excised nevus were reviewed along with immunohistochemical studies, which led to the definite diagnosis of nevoid melanoma (Breslow thickness 1.44 mm; fig. 2).