Case Number : Case 21 Posted By: Guest

Phillip McKee - Overseas consultations (USA) Wrote:

Firstly you are all correct. This is a Merkel cell carcinoma. I put the image in as the trabecular growth pattern is rare. I really appreciate the very kind comments that you have all beeen making. Unfortunately, I cannot do weekends as I need to keep time for my 4th edition which is nearing completion and also another book which may appeal to you all, co-authored with Nooshin Brinster, Vince Liu and Hafeez Diwan. It has a user friendly bulleted format with treatment in addition to clinical and histology. It should come out at the end of the year. there will be over 2000 new illustrations.

Submitted on 08/07/2010 20:25
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Luis Miguel Cabrera Tobar - HICIAB (Guatemala, Guatemala) Wrote:

Carcinoma de celulas de Meckel (Merckeloma, Merckel cells carcinoma)

Submitted on 08/07/2010 19:00
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Ralf - (UK) Wrote:

I would also go for Merkel Cell Carcinoma

Submitted on 08/07/2010 18:10
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Marwa M.Fawzi - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt) Wrote:

Merkel cell carcinoma.

Submitted on 08/07/2010 17:57
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Dear Dr McKee, thank u very much for ur nice words. We are so lucky that u r sharing with us ur wounderful collection.I wait for the quiz every day and as Eman said I miss it on weekends. It is really so educational as it provokes a lot of reading and thinking and thus it helps in solidifying the information and fixing it in our minds. I am waiting for the launch of the online course. I will definitly join it. Mona

Submitted on 08/07/2010 17:35
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Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt.) Wrote:

Thank you Dr Mckee for this effort.I am so grateful for you.Its really amazing educational site.I look foreword for the spot diagnosis daily and miss it so much on saturdays and sundays.Thanks again.

Submitted on 08/07/2010 17:07
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

Given the striking trabecular growth pattern, I favour a Merkel cell carcinoma.

Submitted on 08/07/2010 16:34
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Phillip McKee - Overseas consultations (USA) Wrote:

It is nice to see so many of you posting comments. You are all doing very well. It seems that we have the cream of dermatopathologists visiting the site!!

Submitted on 08/07/2010 15:41
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

I think I can see from this image that this is a tumor made of 2 parts, the left part is like Merkel cell carcinoma with the classic small round cells, the rest of the lesion is trabecular and made of larger cells. I am thinking of Merkel cell carcinoma as a first possibilty. Other neuroendocrine tumors with trabeculae may also be considered as a ddx such as neuroendocrine adenoma.

Submitted on 08/07/2010 15:27
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Rodrigo Restrepo - UPB (Mdlln, Colombia) Wrote:

Merkel cell carcinoma (trabecular carcinoma)

Submitted on 08/07/2010 14:45
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Marcela Saeb Lima - MSL Dermatopato (Mexico, City) Wrote:

There are two cells populations, one of bigger cells in a trabecular pattern and the other more basaloid with some lymphocytes. I have two differential diagnoses: a spiradenocarcinoma vs a Merkel cell carcinoma with both large and small cells. A closer view would help a lot!

Submitted on 08/07/2010 14:36
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Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt) Wrote:

Merkel cell carcinoma.

Submitted on 08/07/2010 12:59
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M Singh - Trainee (UK) Wrote:

The area on the left gives the appearances of a Merkel Cell Carcinoma/ Small cell carcinoma. Area on the right the cells are large with slightly more cytoplasm. Cords and trabeculae of tumour cells. Immuno' to confirm.

Submitted on 08/07/2010 11:02
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Rachel - (Manchester) Wrote:

I see cords and strands with high N:C and suspect nuclear moulding, desmoplastic stroma and surrounding lymphoid infiltrate, has a neuroendocrine feel - ?met. Need immunos

Submitted on 08/07/2010 10:40
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HAE - (London) Wrote:

Cords of cells with high N/C ratio and a hint of nuclear moulding,with an attempt to form rosettes. The stroma is desmoplastic with surrounding lymphoid infiltrate. DD: poorly differentiated carcinoma-probably of neuroendocrine origin-Merckel's cell carcinoma is a possibility. Higher power to see nuclear features and immunohistochemistry will be useful.

Submitted on 08/07/2010 09:39
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Carlos L. - (Spain) Wrote:

Difficult case - itching to go to high power Dr McKee! I wonder about melanoma, lymphoma, poorly differentiated carcinoma. Beautiful image - thank you once again for offering us this daily educational case.

Submitted on 08/07/2010 09:18
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Mo - (India) Wrote:

Cords of cells with crush artefact - high NC ratio - is this a cutaneous lymphoma e.g. diffuse large B cell type

Submitted on 08/07/2010 09:07
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