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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 1219 - 24 February 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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51 year old woman with a mass on the right hand.

Case posted by Dr Uma Sundram


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Myxoid nerve sheath tumour, either a nerve sheath myxoma or a microcystic/reticular schwannoma.

[url="http://www.ncbi.nlm.nih.gov/pubmed/16148415"]http://www.ncbi.nlm.nih.gov/pubmed/16148415[/url]

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Guest Romualdo

Posted

Another possibility is reticular perineurioma. My choice is nerve sheath myxoma. EMA, S100 and GFAP immunostaisns will be very important to arrive at the correct diagnosis.

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Dr. Mona Abdel-Halim

Posted

First impression: nerve sheath myxoma. The nature of the given immunostain is not mentioned.

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Having looked through Zsolt Argenyi's book, Cutaneous Neural Neoplasms, there are photographs of a tumour (pages 66 and 67) which is not that dissimilar to this tumour and which he calls "pseudoglandular schwannoma". Reticular perineurioma is, indeed, a possibility; but I do not think EMA would stain as strongly as does in the last photograph (which I presume is S100), as ordinary perineuriomas stain weakly and unevenly with EMA.

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[color=#000000][font=arial, helvetica, clean, sans-serif][size=3]Aggressive digital papillary adenocarcinoma.[/size][/font][/color]

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Uma Sundram

Posted

Nerve sheath myxoma. The stain is s100. Ema is negative and GFAP was not done.

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