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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 884 - 7th November Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

60 year-old male with vulvar lesion.

Case posted by Dr. Hafeez Diwan.


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User Feedback


Guest Maria George

Posted

Agree with Engin and with out history you may discuss chemotherapy effect.

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Guest Rodrigo Restrepo

Posted

Differentiated vulvar intraepithelial neoplasia

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Robledo F. Rocha

Posted

Is the patient a female one or a transsexual one with a neovulva?

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Guest Romualdo

Posted

In Picture # 4 there are some isolated large cells with large irregular nuclei and clear cytoplasm, in contrast to normal keratinocytes around them. I think this could be Paget's disease or, less probably, pagetoid VIN.

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Agree with VIN, but reluctant to make the diagnosis of differentiated VIN as it is rarely diagnosed in pure forms, usually adjacent to an invasive vulval SCC!!

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Robledo F. Rocha

Posted

Even though dysplastic keratinocytes can be found at all levels of the epidermis, the most atypical cells are confined to the lower one-third. So, I would call this VIN 1.

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Dr. Hafeez Diwan

Posted

The neoplastic cells are very hyperchromatic, instead of being the typical lighter pagetoid appearing ones. This is extramammary Paget's disease. CK7 and CEA were positive in the tumor cells. I have seen a few extramammary Paget's cases where the tumor cells were very hyperchromatic.

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Guest Maria George

Posted

Difficult case.Well done for [color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4][right]Romualdo who thought about the correct answer.[/right][/size][/font][/color]

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