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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 948 - 10th February 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)
The patient is a 69 year old woman with a shave biopsy of a lesion on the left upper lateral lip.

Case posted by Dr. Mark Hurt
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  Report Record
Go to records February 2014

User Feedback


Guest Saleem Taibjee

Guest Saleem Taibjee

Posted

My first thought is rather exuberant pyogenic granuloma / granulation tissue.
But I suspect that Mark would not submit that, so there is obviously a catch, and immunos will probably surprise.

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Guest Tiberiu Tebeica

Guest Tiberiu Tebeica

Posted

The low power temptation is to call this a pyogenic granuloma. Although I am not convinced I see interstitial clumps of purplish material, since there are obvious neutrophils and nuclear dust in the deep aspect of the biopsy and not only confined to the ulceration, I cannot exclude bacillary angiomatosis. As my personal experience with Warthin-Starry is rather disappointing, I would ask also for GMS and maybe a Giemsa. Of course, IHC staining for Bartonella would be indicated. The clinical history might be of help.

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Guest Maria George

Guest Maria George

Posted

If not PG then Cutaneos angiomatous nodule (CAN)

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

Given the proliferation of blood vessels with prominent endothelial cells accompanied by interstitial inflammatory infiltrate, I favor bacillary angiomatosis or, if there is history of exposure to endemic areas, verruga peruana. Looking forward for Warthin-Starry stain.

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Guest Romualdo

Guest Romualdo

Posted

Agree, bartonellosis, possibly bacillary angiomatosis in an immunocompetent individual.

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