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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 736 - 11 Apr Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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40 years-old male with lesion on left nasal ala. Clinical impression is BCC vs nevus vs other.
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Guest Dr Engin Sezer

Guest Dr Engin Sezer

Posted

Cellular neurothekeoma (suggesting NKIC3, NSE, SMA)

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Sasi Attili

Sasi Attili 85

Posted

Cellular Neurothekeoma: Would stain for S100 (-ve); NKIC3, NSE and CD10 (+ve)

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Guest
Agree with Dr. Sezer and Dr. Attili, cellular neurothekeoma

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Guest Romualdo C. L. Filho

Guest Romualdo C. L. Filho

Posted

I agree with my colleagues: cellular neurothekeoma.

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

Dermal-confined plexiform strands of epithelioid cells with faint cytoplasm embedded in a myxoid stroma.
Agree with all: cellular neurothekeoma.

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Guest Mauricio Yamashita

Guest Mauricio Yamashita

Posted

I agree that the main hypothesis is cellular neurothekeoma. But it seems to me that the nuclei are a bit more hyperchromatic and pleomorphic than I would like to see. It might be my lack of experience (I've only seen one case of cellular neurothekeoma) but I wouldn't feel confortable diagnosing this without immunohistochemistry. I would check for more exotic diagnosis like a mucinous carcinoma (one of the cells at the bottom of the third picture seem to have an "intracytoplasmatic lumen") or a myxoid chondrossarcoma infiltrating the skin (unlikely I know, but hey, strange things do happen :D).

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Looks interesting. Cellular Neurothekoma did not cross my mind as a first impression. The stroma is chondromyxoid to me. My first impression was cutaneous myoepithelioma. Definitely IHC is needed. Will love to know the final diagnosis.

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Guest celso

Guest celso

Posted

What about "Myxoid plexiform fibrohistiocytic tumour".

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Guest Bansal_

Guest Bansal_

Posted

This case is a rather challenging case for me. DD: melanocytic lesion, myxoid fibrous histiocytoma and neurothekeoma. Like Dr Hurt, I am uncertain of the likely diagnosis.

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Dr. Hafeez Diwan

Dr. Hafeez Diwan 125

Posted

Like the majority, I went with cellular neurothekeoma. S-100 was negative. Complete excision was recommended.

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