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.
Submitted Date :
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40 year old female nurse with large lesion on left buttock.

Case Posted by Dr Uma Sundram


User Feedback


Raul Perret

Posted

My differential is between cellular dermatofibroma with atypical/monster cells vs dermatofibrosarcoma protruberans. Should perform IHQ: CD34, FXIII, SM;, there is epidermal induction (much more frequent in dermatofibroma than DFSP), pseudovascular spaces and an equivocal infiltration of the hypodermis (can be seen in atrophic and plaque-like variants of DFSP). The pleomorphic cells can be seen in both entities as DFSP can have areas simulating giant cell fibroblastoma (here we dont see floret cells in the pseudovascular spaces. Agree with Vincenzo, I incline more to cellular Dermatofibroma with monster cells. Just as a last comment watching this case made me remember of this one (dont know if you agree) that Dr. Sundram presented not a long time ago, cells in that case look a little bit more epithelioid but It still amazes me the morphology an epithelioid sarcoma can adopt.

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Nitin Khirwadkar

Posted

Agree, cellular dermatofibroma with monster cells vs DFSP. Epidermal induction has been described with DFSP , Am J Dermpath 2014. IHC and may be pDGF/COLLIA fusion.

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Dr. Mona Abdel-Halim

Posted

Cellular fibrous histiocytoma (with monsterous cells).

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Guest Romualdo

Posted

I think there is too much atypia for DFSP. I go with dermatofibroma with monster cells.

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vincenzo polizzi

Posted

this is such a great web site where even an old pathologist like me feel young and strong and continues learning more and more...thanks to all!!!

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