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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 982 - 28th March 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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F48. Scalp lesion ?benign naevus, ?adnexal tumour

Case posted by Dr. Richard Carr.


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My first impression was intradermal naevus, but I expect there's more to it; so maybe cellular neurothekeoma or non-neural granular cell tumour.

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Dr. Mona Abdel-Halim

Posted

First impression: cellular neurothekoma.

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Eman El-Nabarawy

Posted

Cellular neurothekoma is a poorly circumscribed tumor. I favor non-neural dermal granular cell tumor.

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Dr. Richard Carr

Posted

Immunostains as follows: CD68++; CD10++ diffuse; Weak focal CD56; S100, MelanA, HMB45, EMA, Mac387, MNF116, Cam5.2 all neg. NKI-C3 diffuse ++ (c/o Dr Eduardo Calonje) & PGP9.5+90%. Hope this helps.

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Dr. Mona Abdel-Halim

Posted

Cellular neurothekoma, first impression confirmed.

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Robledo F. Rocha

Posted

Superficial intradermal nested epithelioid cells in a hyalinized background favoring cellular neurothekeoma.

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Mark A. Hurt MD

Posted

Another consideration is to apply D2-40 and NSE, which, to my understanding, are also positive in "cellular" neurothekeomas.

http://www.ncbi.nlm.nih.gov/pubmed/?term=19318798

http://www.ncbi.nlm.nih.gov/pubmed/17325474

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Dr. Richard Carr

Posted

Well done all. I also favoured cellular neurothekeoma and the case was kindly stained for NKI-C3 by Dr Eduardo Calonje who concurred with the diagnosis. In my experience of other cases a nested pattern resembling naevus can be a clue to the diagnosis in addition to the sclerotic stroma as seen nicely in this case.

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