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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 1611 - 29 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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18 year old female: Inflamed area of skin anterior neck 1 cm X 4 mm. Several months. Scales. Static size. ? Localized infection folliculitis. ?sup BCC. 4 mm punch biopsy taken.

Case Posted by Dr Iskandher Chaudhry


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Raul Perret

Posted

Agree, a developmental cyst with histologica features consistent with bronchogenic cyst

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Iskander H. Chaudhry

Posted

Interesting - does the site and superficial location fit with the diagnosis ? 

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vincenzo polizzi

Posted

Bronchogenic cysts are usually present near manubrium stern but have been reported on the anterior neck. I see some serous-mucous gland in fig1, as minor salivary glands of bronchial wall...more difficult form me is answer to superficial site question. I know superficial site doesn't fit with thyroglossal cyst, but why not with BC?

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Dr. Mona Abdel-Halim

Posted

I thought of mucinous syringometaplasia

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Raul Perret

Posted

I agree with the points remarked by Vincenzo. There is a lot of controversy in the definition of developmental cysts, the distinction between thyroglossal cyst, bronchogenic cyst and branchyal cyst can be sometimes difficult as they can all share similar histological images. CPC is important as well as images, that is why I prefer doing a diagnosis of developmental cyst in favour of ... the presence of the submucosal glands was the reason of my inclination towards Bronchogenic cyst. Another differential is cutaneous cyliated cyst but this entity is mainly described in the extremities of females and is of mullerian origin not quite the aspect of epithelium seen here.

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Raul Perret

Posted

Mucinous syringometaplasia is a nice remark by Mona, however how could we explain the presence of cilia and the submucosal glands?

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Dr. Mona Abdel-Halim

Posted

May be these are not submucosal glands Raul, may be they are just mucinous metaplasia extending to the secretory coils??

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Nitin Khirwadkar

Posted

Have read all the above. Still think in terms of a bronchogenic cleft cyst.

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vincenzo polizzi

Posted

I see a SEROmucinous gland in fig 1, consistent with submucosal bronchial gland. and that's why I think of a bronchogenic cyst.

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Dr. Mona Abdel-Halim

Posted

After checking the images again and again and some reading; I think you are right Raul that the lining is ciliated. Now based on location I am thinking of thyroglossal duct cyst. Lining can be ciliated. It is not uncommon to have an associated sinus opening. The adjacent tissue may contain mucous glands or thyroid follicles. What we have in image 1 could be mucous glands or colloid containing thyroid follicles (similar to a picture in McKee), although I wished to c a higher magnification of these structures.

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Nitin Khirwadkar

Posted

Mona, I think you are right. A thyroglossal duct cyst can show these changes, and clinically fits better.

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