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A magnification assessment has shown that the tumor had a blunt ��pushing-type�� border with a sharp demarcation line between the tumor and the dermis or subcutaneous tissue (Figure 1(d)). However, in some foci the LDK378 molecular weight tumor showed more irregular infiltrative borders (Figure 1(e)). Perineural invasion was present (Figure 1(f)). Tumor necrosis was not observed but in the central part of the lesion a cystic degeneration was present (Figure 2). The morphology was consistent with CBN but somehow suspicious, especially taking into consideration the history of nodular melanoma operation a year before. Therefore, additional immunohistochemical (HMB-45, p16, and Ki-67) and molecular (BRAF V600E mutation) analyses were performed on CBN-like and NM. Figure 1 A pigmented lesion consisted with cellular blue nevus with an expansive pattern of extension into dermis and subcutaneous adipose tissue (a) and a spared papillary dermis (b). Cellular islands of closely aggregated spindle shaped cells with ovoid nuclei ... Figure 2 A central part of pigmented lesion with cystic degeneration, small foci of hemorrhage (a), and multinucleated cells that are a common finding in cellular blue nevus Quetiapine (b). Immunostaining with HMB-45 was strongly positive in more than 80% of tumor cells in NM (Figure 3(a)) while reactivity was focally present at the periphery of alveolar nets in CBN-like (Figure 3(d)). p16 was present in more than 60% of tumor cells (Figure 3(e)) in CBN-like while melanoma cells were negative (Figure 3(b)). Ki-67 staining was almost negative in CBN (buy AG-014699 (a) while in CBN the reactivity was mostly present at the periphery of alveolar nets (d); p16 was negative ... 3. Discussion The current case presents CBN as a less common form of blue nevus that additionally contained some atypical features which required a differentiation from malignant blue nevus, especially because the patient presented with a history of excised melanoma. Most melanomas are thought to arise de novo; however, they may develop in association with a preexisting benign melanocytic lesion. In addition, the term ��malignant blue nevus�� has been applied most often to melanomas that arise in the background of cellular blue nevus [15�C17]. In the literature there are some reported cases of melanoma that arose in a congenital CBN in older patients (73 and 69 years) with a predilection for the scalp area [18, 19].