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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 1018 - 19th May 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 67 year old white man with a shave biopsy of a jet black, firm nodule without a keratotic component, present for over one year, taken from the area behind the right ear.

Case posted by Dr. Mark Hurt.


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Eman El-Nabarawy

Posted

Baso-squamous melanocytic tumor.

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Dr. Mona Abdel-Halim

Posted

I think this is pigmented BCC colonized with dendritic melanocytes. I think in basomelanocytic tumor or in squamomelanocytic tumor, there is collision of BCC or SCC with a melanoma. I do not think we have melanoma cells here, we just have dendritic melanocytes colonizing a basaloid cell tumor with peripheral palisading and peritumoral clefting. Melanophages are also abundant in the stroma.

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Robledo F. Rocha

Posted

[font="Arial, sans-serif"][size=4][color="#000000"]Basal cell carcinoma colonized by n[/color][color="#000000"]umerous [/color][color="#000000"]non-neoplastic [/color][color="#000000"]dendritic melanocytes scattered throughout the [/color][color="#000000"]tumor lobules[/color][color="#000000"].[/color][/size][/font]

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Guest Romualdo

Posted

Agree: pigmented basal cell carcinoma colonized by dendritic melanocytes.

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Guest Jim Davie MD

Posted

Agree: pigmented nodular BCC.
Low mitotic activity, peripheral palisading, retraction artefact, trabeculated nodular architecture. Dendritic melanocytes throughout, suggestive of an indolent BCC vs. trichoblastoma.
CK5/6 is positive in both SCC and BCC. BerEP4 is weak diffuse positive, and there is evidence of squamous differentiation focally (which may show up with EMA).

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BCC ( pigmented nodular type). i agree with comment for Dr Mona and Dr Davie

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Mark A. Hurt MD

Posted

My diagnosis was basal cell carcinoma with dendritic melanocytes. I have seen this phenomenon relatively commonly in BCC, but I have also seen it in seborrheic keratoses ("melanoacanthoma").

Thanks, everyone, for getting straight to the heart of it.

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