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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 669 - 7 Jan 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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47 year old male, lesion on cheek.
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Go to records January 2013

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Azza Esmat

Azza Esmat 0

Posted

B-cell lymphoid hyperplasia

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Sasi Attili

Sasi Attili 85

Posted

pseudolymphoma vs PCFCCL. Favour the former.

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Arif Usmani

Arif Usmani 17

Posted

I would also include Rosai-Dorfman disease in the differential. There is a background of histiocytic infiltrate with more than a sprinkling of lymphocytes and plasma cell with prominant vascularity. It is hard to determine if there is a true emperipolesis in the given pictures.

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Guest Hazem Hamed

Guest Hazem Hamed

Posted

Really I can't appreciated the cellular details in images (3&4). But I think the infiltrate is lymphohistiocytic (granulomatous) with a few admixed eosinophils. I would add granulomatous diseases like, leprosy, Lesihmania and less likely Granuloma faciale in DD.

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Guest A Z
My first impression was sarcoidosis (naked granulomas), however, I would add other causes of granulomas including infectious causes in the DD. I could not identify pockets of plasma cells nor empropolesis.

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Dr. Phillip McKee

Dr. Phillip McKee 130

Posted

The presence of a nodular very heavy lymphoid infiltrate with granulomata is certainly consistent with a B-cell pseudolymphoma. I also agree that infections should be excluded including leishmaniasis.

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Arif Usmani

Arif Usmani 17

Posted

Agree with Dr. Hamed an infectious process such as leprosy is a good thought as well.

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