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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 1350 - 26 August 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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76 year-old male with scrotal mass.

Case posted by Dr Hafeez Diwan


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Dr. Mona Abdel-Halim

Posted

With the unlabeled immunos, I am struggling !!!!!!!!
Will try:
A spindle cell neoplasm with a collagenous/myxoid background.
The second, third and fourth images show large bizarre cells, the second image also shows a cell with cytoplasmic vacuoles ( thought of it as ? lipoblast). The last two images show perivascular collections of cells with foamy/bubbly cytoplasm. Could it be a liposarcoma (paratesticular liposarcoma)??? I am thinking of the spindle cell type type of atypical lipomatous tumor/well differentiated liposarcoma????
I might be wrong though.. I am not expert in this area and I would love to know the correct diagnosis.

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Arti Bakshi

Posted

Struggling too!
What about pleomorphic hyalinising angiectatic tumour?
Not sure about the nature of the perivascular cells with cytoplasmic vacuolation!

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Guest Romualdo

Posted

My opinion is PHAT too. Ganglion-like cells have been described in this condition. The vacuolated cells are reminescent of pseudolipoblasts seen in myxoinflamatory fibroblastic sarcoma, a related neoplasm. Last immuno image is probably CD34, that is positive in PHATs. Anxious to know the correct diagnosis!

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Dr. Mona Abdel-Halim

Posted

Looks like Arti and Romualdo got it right :-))

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Dr. Hafeez Diwan

Posted

Sorry for the unlabeled immunos. Both are CD34 (you can see the vessels). I called this pleomorphic hyalinizing angiectatic tumor (CD34 is positive).

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Dr. Mona Abdel-Halim

Posted

Well done Arti :-))
Well done Romualdo :-))

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