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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 933 - 20th 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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The patient is a 77 year old white woman with a shave biopsy taken from the upper aspect of the back.

Case posted by Dr. Mark Hurt
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Go to records January 2014

User Feedback


Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

Plexiform schwannoma.
(Presence of capsule and palisading favor it over plexiform neurofibroma).

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IgorSC
Agree with plexiform schwannoma. The capsule is a good tip. S-100 and EMA stains are helpfull.
I think that If this diagnosis were plexiform neurofibroma the patient would probably have Neurofibromatosis.

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Guest Dr.Yüksel Okumuş

Guest Dr.Yüksel Okumuş

Posted

After these images, the diagnosis must be palisaded encapsulated neuroma

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

My diagnosis is palisaded encapsulated neuroma, plexiform pattern.

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

Yes. Solitary circumscribed neuroma (Palisaded encapsulated neuroma)

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Guest Romualdo

Guest Romualdo

Posted

Agree with palisaded encapsulated neuroma, plexiform variant.

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Guest Saleem Taibjee

Guest Saleem Taibjee

Posted

agree, plexiform schwannoma.
Main issue is to distinguish from plexiform neurofibroma, since the latter is virtually pathognomonic of NF1

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

So it's solitary circumscribed neuroma.

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

In my experience plexiform neurofibromas are deeper subcutaneous lesions and are entirely encapsulated and surrounded by perineurium although I have seen some odd dermal hybrid lesions that I could not fit neatly. I don't think this is a plexiform neurofibroma however. Like colleagues above I was thinking of a plexiform schwannoma on the initial images but feel it is either a hybrid with or just a plexiform variant of encapsulated neuroma. Don't expect lesions to read text-books and hybrids seem to be ever more common!

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I still think it is palisaded encapsulated neuroma, plexiform variant.

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