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

Case posted by Dr Uma Sundram


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Eman El-Nabarawy

Posted

Epithelioid angiosarcoma.

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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

Posted

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

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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

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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