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Building Blocks of Dermatopathology

BAD DermpathPRO Learning Hub: Basics of Immuno

Course Overview

Case Number : IM0011 Admin_Dermpath

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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31 years-old pregnant female, ulcerated nodule.

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Operations Pathhub


Dr. Mona Abdel-Halim - I am not comfortable with this lesion. Cells with spitzoid features are scattered diffusely in the dermis, not nested, S100 positive, so spitzoid melanocytes, I think there is a deep mitosis?? Is this a spitzoid melanoma??
Sasi Attili - Agree with Mona. Has to be a melanoma, in a pregnant woman! 

Robledo F. Rocha - Amelanotic atypical cells embedded in a markedly fibrotic stroma with patchy lymphocytic infiltrates. Immunohistochemical study shows strong and diffuse S100 staining that extends throughout the full thickness of the dermis, what excludes any evidence of maturation with depth. Atypical cells are epithelioid with abundant eosinophilic cytoplasm. I think it’s a desmoplastic melanoma with spitzoid features.
Pathanon - DD: Desmoplastic melanoma, desmoplastic spitz naevus. Favour former.
Guest Dr Engin Sezer - Desmoplastic melanoma
Dr. Phillip McKee - This is a mixed spindled cell (Fig 2) and desmoplastic (Fig 3) melanoma. I don't see any spitzoid features.

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