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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1171 - 18th December 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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75 year-old male with a biopsy from left posterior scalp. Previously, he had a squamous cell carcinoma in this area. A CD10 immunohistochemical study is included.

Case Posted By Dr.Hafeez Diwan


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Spindle-cell non-pleomorphic AFX, presuming the usual markers are negative.

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Probably spindle cell AFX, but I would be more confident after seeing SOX-10 and p63.

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Guest Romualdo

Posted

CD10 in isolation is not sufficient to distinguish AFX from spindle cell squamous carcinoma. The latter may show diffuse and strong positivity with this marker. I think this is spindle cell carcinoma. Let's wait for the other markers, specially p63.

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Robledo F. Rocha

Posted

Given the case history, I favor recurrence of squamous cell carcinoma, spindle cell type. Like Romualdo said, CD10 alone in not enough to distinguish atypical fibroxanthoma from spindle cell squamous cell carcinoma, and other immunostainings are needed, including p63 and cytokeratin markers.
[url="http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0560.2011.01768.x/abstract"]http://onlinelibrary...1768.x/abstract[/url]

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Dr. Hafeez Diwan

Posted

Desmoplastic melanoma. S-100 was diffusely positive. CK5/6 was negative.

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