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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 1592 - 02 August 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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40 year old female nurse with large lesion on left buttock.

Case Posted by Uma Sudram


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biswanath behera

Posted

Epidermal induction, grenz zone, ill defined lesion extending upto subcutaneous tissue, blood filled area not lined by endothelial cells, collagen trapping, cellular pleomorphism

Aneurysmal dermatofibroma or DFSP

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Dr. Richard Carr

Posted

Agree with your differential. Low power looks concerning for DFSP - relatively monotonous but the typical epidermal hyperplasia, focal atypical cells and only focal involvement of superficial subcutis favour atypical FH/DF.  I therefore favour the latter (CD34 should be helpful).  I'm not sure where the original discussion of this case went! 

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Uma Sundram

Posted

Atypical fibrous histiocytoma. CD34 was positive in the center of the lesion but factor 13a blazingly positive. Could not do cytogenetics, unfortunately. There was an IT issue last week with this case but am glad you all got to see it eventually!

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