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 1388 - 19 October 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)

The patient is an 88-year-old white man with an excision with margin exam taken from the left cheek. Clinical Diagnosis: Neoplasm of unknown diagnosis.

Case posted by Dr Mark Hurt


  Report Record

User Feedback


Arti Bakshi

Posted

Desmoplastic trichilemmoma.
Is there suggestion of ducal differentiation in image 6? Acc to kazakov, this is a rarely described feature of trichilemmoma, particularly desmoplastic variant.

Share this comment


Link to comment
Share on other sites

Mark A. Hurt MD

Posted

The CD34 was completely negative, and Ber-EP4 was positive throughout. Does this alter your diagnosis?

Share this comment


Link to comment
Share on other sites

Arti Bakshi

Posted

The immunoprofile would suggest BCC, but difficult to reconcile morphological findings with BCC i.e. no retraction, stromal mucin and bland cytology plus a clearly thickened basement membrane.
Would probably still stick with desmoplastic trichilemmoma…but waiting to be educated!

Share this comment


Link to comment
Share on other sites

Dr. Mona Abdel-Halim

Posted

The immunos will make it BCC, the surface is ulcerated and there is focal stromal retraction. The centre is morpheaform or sclerotic BCC.

Share this comment


Link to comment
Share on other sites

Mark A. Hurt MD

Posted

My diagnosis, in the end, was BCC. Admittedly, I thought this was a tricholemmoma by H&E, but the immunos were so convincingly negative (for CD34) and positive for ber-ep4 (and CD10) that I classified this as BCC.

My take home point is that there is a class of BCC's that is a mimic for tricholemmoma by H&E (and some tricholemmomas mimic BCC's)

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...