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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1234 - 17 March 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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80 year old woman with 5 mm hemorrhagic lesion on the scalp.

Case posted by Dr Uma Sundram
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  Report Record
Go to records March 2015

User Feedback


Guest Jim Davie MD

Guest Jim Davie MD

Posted

Metastatic renal cell carcinoma (conventional clear-cell type) to be added to the differential.

Scattered clustered acinar foci of foamy water-clear epithelioid cells, with similar atypical nuclei as the infiltrative component (visible on low and high power images). There appears to be small brown hemosiderin deposits in the cytoplasm of the clear cells that (if actually hemosiderin) are useful for differentiating metastatic RCC from other similar metastatic lesions.

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Arif Usmani

Arif Usmani 17

Posted

Agree with Jim. IHCs needed to rule out RCC or other metastatic possibilities.

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HENRY
I also think this is a mets..most likely metastatic Renal cell carcinoma given the rich vascularity and focal clear cell changes

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Uma Sundram

Uma Sundram 169

Posted

Agree with your differential. The epithelioid cells were positive for CD34, CD31 and erg, confirming vascular origin. Diagnosis-epithelioid angiosarcoma.

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