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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 931 - 16th January 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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40 year-old male with lesions on arm.

Case posted by Dr. Hafeez Diwan.


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Eman El-Nabarawy

Posted

First impression was nodular Kaposi's sarcoma. But after noticing a lot of epithelioid cells and intracytoplasmic vacuoles, I'd like to add spindle cell hemangioma to the DD although lacking cavernous vascular channels (may be in other sections!!).

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I agree with Eman El-Nabarawy comment. But, as I can not see the cavernous vascular spaces, I think this is the more common Kaposi sarcoma. Apart from these two hypotheses, I don´t see any more differential diagnosis.

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Robledo F. Rocha

Posted

Agree with my colleagues and favor nodular stage of Kaposi sarcoma. Epithelioid cells with cytoplasmic vacuoles are suggestive of spindle cell hemangioma, but they seem to be only a focal finding.

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Mark A. Hurt MD

Posted

Kaposi's sarcoma until or unless proven otherwise.

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Guest Jim Davie MD

Posted

Kaposi's sarcoma, tumor stage. Supportive findings include:
1. Hypercellular nodules in the deep dermis, with Intersecting fascicles of mildly atypical hyperchromatic spindle cells in parallel arrays, and erythrocytes filling innumerable, small slit-like spaces (seen best in the top right photomicrograph).
2. Patch-stage findings in the more superficial dermis, with sparse hyperchromatic cells surrounding dermal collagen fibers in a promontory-sign pattern (seen best in top left photomicrograph).

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