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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 336 Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Male 43 years, painless nodule on trunk.
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  Report Record
Go to records September 2011

User Feedback


Admin_Dermpath

Admin_Dermpath 1,217

Posted

Mona Abdel Halim - Dermatology Dept. Cairo University (Egypt) Wrote:

What about epithelioid mesothelioma with metaplastic osteoid

Submitted on 22/09/2011 16:01
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Phillip McKee - Overseas consultations (Cave Creek, Arizona, USA) Wrote:

Well done Bostjan, the giveaway to the diagnosis is the focus of osteoid at the edge seen in fig 1. It is still a very dificult case.

Submitted on 22/09/2011 13:35
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Mona Abdel Halim - Dermatology Dept., Cairo University (Egypt) Wrote:

Very difficult case, I have been thinking for a while, I can perceive polyhydral epithelioid like cells with pale esinophilic cytoplasm, ? finely granular in some areas, ? clear cytoplasm in some areas, I also can c many blood vessels within the tumor, I have this perception that the tumor cells r intimately related to the blood vessels, so I was thinking of perivascular epithelioid cell tumor (PECOMA). I have the read that the cells can range from clear to esinophilic granular... I am not sure actually.. If not PECOMA, then I will consider granular cell tumor like Eman said but may be I will prefer the primitive non neural granular cell tumor (no pustulo-ovoid bodies).. I think the nuclei in myoepitheliomas r more vesicular.

Submitted on 22/09/2011 10:46
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Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:

I thought of a myoepithelial neoplasm vs epithelioid nerve sheath tumor....

Submitted on 22/09/2011 07:57
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Difficult case really!! Thought of granular cell tumor.Less likely myoepithelioma.

Submitted on 22/09/2011 05:23
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Bostjan Luzar - Institute of Pathology, Medical Faculty University of Ljubljana (Ljubljana, Slovenia) Wrote:

Very difficult from HE alone. A focus of metaplastic bone is seen in Fig 1. Cells are fairly uniform and round. Could this be an ossifying fibromyxoid tumour? Not many myxoid areas, though.

Submitted on 22/09/2011 04:30
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