Case Number : Case 18 Posted By: Guest

Phillip McKee - Overseas consultations (USA) Wrote:

The diagnosis is acute myeloid leukemia although it is obviously not possible to come to this diagnosis without clinicopathological correlation and immunohistochemistry and histochemistry. It is amazing how often the clinician will not tell you that the patient suffers from leukemia! The point of the image is to remind you to always think of leukemia when your first thought is a lymphoma or other small blue cell tumor.

Submitted on 05/07/2010 20:57
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Donald Carman - (USA) Wrote:

Hope I have got in just in time. The difficulty with this case is the cells look medium sized to me and not that large so I was not keen on the diagnosis of ALL or DBL. Leukaemia or small to medium sized pleomorphic T cell lymphoma are high on my list.

Submitted on 05/07/2010 20:54
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Rodrigo Restrepo - UPB (Mdlln/Col) Wrote:

Diffuse large B Cell lymphoma. DD cutaneous infiltration by myeloid leukaemia

Submitted on 05/07/2010 18:54
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Phillip McKee - Overseas consultations (USA) Wrote:

Miah Singh is doing very well

Submitted on 05/07/2010 18:24
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Mo - India () Wrote:

Lymphoid neoplasms - like Miah's dd - nice images

Submitted on 05/07/2010 18:17
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Miah Singh - (UK) Wrote:

This is a really challenging case. I prefer lymphoid over melanocytic and dd includes: Anaplastic large cell lymphoma, Diffuse B cell lymphoma, Monocytic myeloid leukaemia, and Langerhan's histiocytosis.

Submitted on 05/07/2010 16:34
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Jonathan Shelton - (UK) Wrote:

I would also consider naevoid melanoma. If lymphoid then large cell lymphoma or transformed MF

Submitted on 05/07/2010 16:16
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Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt) Wrote:

B-cell lymphoma

Submitted on 05/07/2010 15:55
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

If these are melanocytes, I would favour a naevoid melanoma. If the population is lymphoid, I would favour a non-Hodgkin lymphoma.

Submitted on 05/07/2010 14:45
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Phillip McKee - Overseas consultations (USA) Wrote:

This is a difficult spot diagnosis and is meant to make you think in terms of differential diagnoses. It is not possible to come to a definitive diagnosis on this one image. Have fun! Phillip

Submitted on 05/07/2010 13:56
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

large atypical lymphocytes (some show mitosis), vesicular nuclei, central or eccentric nuleoli. I am thinking of Diffuse large B Cell lymphoma.

Submitted on 05/07/2010 05:23
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Eduwiges Martínez - Hospital Gea González (Trainee) (Mexico, City) Wrote:

lymphoma, I think as a differential diagnosis of Merkel cell

Submitted on 05/07/2010 04:17
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