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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 583 - 3 Sept 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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Female 34 years with a polypoid nodule on the leg thought clinically to be a Spitz nevus. 
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Go to records September 2012

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Sasi Attili

Sasi Attili 85

Posted

Polypoid lesion composed of epithelioid cells in a vague storiform pattern set in a collagenous stroma. No nesting or junctional component. No significant mitoses/ atypia. There is a sparse lymphocytic infiltrate. Epithelioid benign fibrous histiocytoma is my favoured diagnosis. DD includes Spitz (lack of nesting or junctional component against this) and epithelioid perineurioma. Need CD34/ Fac XIIIa, S100, EMA and Claudin-1, to confirm diagnosis.

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Guest
Epithelioid fibrous histiocytoma (with more collagen than usual) vs desmoplastic Spitz naevus. The former favoured.

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Dr. Phillip McKee

Dr. Phillip McKee 130

Posted

Well done Marcela. Ankle type FH is the correct diagnosis. The site of the lesion, the almost hyalinized collagen and clefts are all diagnostic clues.

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