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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 1214 - 17 February 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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65 year old woman with a lesion on the mid nose.

Case posted by Dr Uma Sundram


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Guest Giovanni Falconieri

Posted

Heavy plasma cell infiltrate. If polytypic, I suspect chronic infection (rhinoscleroma?). PAS stain may be revealing

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Guest Romualdo

Posted

Except for some neutrophils near the surface I see a pure plasma cell population. I think this is plasmacytoma.

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Mark A. Hurt MD

Posted

Please see my [url="https://dermpathpro.com/spot-diagnosis-1/_/2015-spot-diagnoses/february-2015/case-1213-16-february-r1266"]diagnosis[/url] on yesterday's case.

MAH

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Eman El-Nabarawy

Posted

Lower part of syringocystadenoma papilliferum.

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Dr. Mona Abdel-Halim

Posted

As my colleague Eman said, this is nothing but Syringocystadenoma Papilliferum... The plasma cells are a clue as well as the tall columner epithelial lining of the papillary projections with a hint of decapitation secretion in some areas...

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Guest Jim Davie MD

Posted

Agree, syringocystadenoma papilliferum.
Nodular plasma cell-rich infiltrate is supportive for the dx, when it is present. I find the dual-layer of surface epithelial cells with basal layer showing cuboidal features, and decapitation secretion/overall papillary architecture as Mona pointed out, most helpful for making the diagnosis in a head/neck cutaneous lesion. (Very rarely these degenerate into syringocystadenocarcinoma papilliferum, but there is no atypia in the surface bilayer, and no invasive component in these sections.)

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Uma Sundram

Posted

I also wanted to add that the plasma cell population was polytypic. No infectious agent was found via special stains.

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