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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 1497- 21 March 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 an 80 year old white man with a shave biopsy of a nonhealing bleeding lesion that gets crusted, present for three months, taken from the mid upper forehead.

Case posted by Dr Mark Hurt
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Go to records March 2016

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Raul Perret

Raul Perret 262

Posted

Due to clinical information and morphology I would consider atypical fibroxanthoma, it bothers me that there is no grenz zone though. Of course a wide panel of immunos should be performed first (CK, P63 or P40, S-100, melanocytic markers, desmin, CD31, CD10). Picture 5 shows some basal membrane thickening I was wondering the cause...

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vincenzo polizzi

vincenzo polizzi 185

Posted

Pleomorphic tumor, sarcomatoid pattern, with perinuclear cytoplasmic clearing, Golgi-like, reminiscent of ALCL, sarcomatous type. Obviously it needs IHC.

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vincenzo polizzi

vincenzo polizzi 185

Posted

I may be wrong but i see several cells with abundant cytoplasm, horseshoe (“hallmark”) nucleus or wreath-like or multiple nuclei, perinuclear eosinophilic region...so i favor Anaplastic Large Cell Lymphoma.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I thought based on morphology of ALCL, but complete IHC work up should be done

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Nitin Khirwadkar

Nitin Khirwadkar 63

Posted

Poorly differentiated tumour, requiring a good panel of IHC. My differentials, pleomorphic dermal sarcoma/AFX, angiosarcoma, pseudovascular SCC, melanoma (unlikely), LMS.

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