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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 680 - 22 Jan 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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62 years old male, nodular on neck.
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Go to records January 2013

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

I think this lesion has a triphasic pattern: thick-walled blood vessels, adipocytes, and interlacing fascicles of spindle cells with focal nuclear atypia. So it could be a rare case of cutaneous angiomyolipoma.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

What about PECOMA?

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Sasi Attili

Sasi Attili 85

Posted

What about all the inflammatory cells? Nodular fasciitis was my first thought, though extravasated RBC are not prominent.

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Dr. Phillip McKee

Dr. Phillip McKee 130

Posted

I think that you are all going to kick yourselves for not paying attention to the lymphocytic aggregates seen in Figs 1 and 4. The tumor is S100 positive and is a recurrent desmoplastic melanoma. Nodular fasciitis would be most unlikely in a patient this age and any event the site is wrong. Pecoma is composed of clear cells. As I have mentioned before, melanocytic lesions seem to cause you all trouble. I think you need to work hard to get a better diagnostic ability on these lesions. In the US, they are the commonest cause for litigation!!!!!!

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