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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 951 - 13th February 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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5 year-old female with a lesion on her chin.


Case posted by Dr. Hafeez Diwan.


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Guest Romualdo

Posted

Agree, T-cell lymphoblastic lymphoma/ leukemia.

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Cutaneous infiltration by lymphoblastic lymphoma. The most important differential diagnosis for this age and case would be a Rhabdomyosarcoma and cutaneous infiltation by PNET/Ewing.

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Leukaemic infiltration. Presumably the patient has a history of ALL.

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Guest Jim Davie MD

Posted

Agree with above differential.

To expand the differential:
Primary cutaneous large cell lymphoma (B-cell or T-cell), rare in the pediatric population. These are frequently LCA (CD45) weak or negative, which can be a potential pitfall, or, (in the context of positive staining for more specific T-cell or B-cell markers), a useful clue to help identify them in the lymphoma differential.

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Robledo F. Rocha

Posted

Lymphoblastic lymphoma / leucemia with skin infiltration.

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Dr. Hafeez Diwan

Posted

B-cell acute lymphoblastic lymphoma/leukemia. There was no prior history. The tumor cells were Tdt, CD10, CD34, Pax-5 and CD20 (lightly) positive.

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