Jump to content
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 1184 - 6th January Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

35 year old man with numerous scattered papules that come and go over a two week period. They heal with a small scar. A fresh papule on the trunk is biopsied.

Case posted by Dr Uma Sundram


  Report Record

User Feedback


I see some atypical lymphocytes, some of them with twisted nuclei, focally into the epidermis. With the clinical history of papules that come and go my fist impression is of a type B Lymphomatoid Papulosis.

Share this comment


Link to comment
Share on other sites

Robledo F. Rocha

Posted

[color="#000000"][font="Arial, sans-serif"][size=4]Agree with Igor. Case history and microscopic images point to type B lymphomatoid papulosis.[/size][/font][/color]

Share this comment


Link to comment
Share on other sites

Sasi Attili

Posted

Agree that histo consistent with LyP. However I have never seen LyP resolve in 2 weeks!! Could this be a LyP like insect bite reaction?

Share this comment


Link to comment
Share on other sites

Dr. Richard Carr

Posted

How about PLEVA (with atypical CD30+ cells). Some cases are viral e.g. parvo B19

Share this comment


Link to comment
Share on other sites

[color="#000000"]Lymphomatoid papulosis. [/color]

Share this comment


Link to comment
Share on other sites

Dr. Mona Abdel-Halim

Posted

I think the atypical cells are so prominent... In PLEVA one can find few atypical cells but here I think the extent of atypia favours LyP.

Share this comment


Link to comment
Share on other sites

Uma Sundram

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case%201184%20-%20SD_US-028-F5.jpg[/img]

Share this comment


Link to comment
Share on other sites

Uma Sundram

Posted

Yes, I too thought lymphomatoid papulosis, and as you can see, CD30 is positive in the larger cells. I wasn't very clear on the clinical history--the lesions were ongoing and had a waxing and waning quality, evolving over a 2-4 week period. The patient almost always had lesions at different stages of evolution, typical of Lyp. As you all know, types A, B and C can merge into each other. These are better described and more easily recognized than the more recent group of Lyp types. PLEVA and insect bites are both great thoughts; PLEVA can be very difficult to distinguish from Lyp. The number of atypical cells seen here are perhaps more numerous than one typically did see in PLEVA; however, early in the discovery of Lyp this entity was thought to be a PLEVA-variant so the clinical is very important. Insect bites are very tricky as there can be significant overlap with Lyp; again, the clinical is very important.

Share this comment


Link to comment
Share on other sites

Uma Sundram

Posted

I forgot to add that in last week's case of pcALCL and this week's case of Lyp, correlation with clinical findings AND clinical follow up are necessary to arrive at the appropriate diagnosis--in some cases, one cannot be sure even with an experienced clinician. That is the tricky aspect of cutaneous lymphomas!! Keeps us on our toes.

Share this comment


Link to comment
Share on other sites



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...