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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1575 - 08 July 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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F35. Scalp nodule.

Dr Richard Carr

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Go to records July 2016

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vincenzo polizzi

vincenzo polizzi 185

Posted

Metastatic neuroendocrine carcinoma, probably mammary ductal carcinoma with neuroendocrine differentiation.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

What about myoepithelioma? waiting for the additional 6pm images.

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Nitin Khirwadkar

Nitin Khirwadkar 63

Posted

A very monomorphic tumour with a nested pattern of growth, separated by a richly vascularised stroma. Obvious atypia, mitoses and in higher magnification some cells have cytoplasmic vacuolation. Would be unusual at this age to have a metastases from a breast primary, although not impossible. Medullary carcinoma thyroid ??? Would wait for further IHC before putting a diagnosis. 

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Raul Perret

Raul Perret 262

Posted

My impression was also poorly differentiated Metastatic adenocarcinoma, should think of mammary primary because of morphology and statistics is it à patient with BRCA mutation? Also considered neuroendocrine diff so would perform neuronendoc markers.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Nice, metastatic thyroid carcinoma

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vincenzo polizzi

vincenzo polizzi 185

Posted

Ok. Poorly differentiated thyroidal carcinoma is a DD. I think so in view of insular pattern with TTF1, because a TTF1 positivity is possible in breast cancer with endocrine differentiation.

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Raul Perret

Raul Perret 262

Posted

Nice suggestion of thyroid primary on the haematoxilin Nitin. The key point in cases of metastatic carcinomas (with unknown primary) is making a wide Immunohistochemical pannel and never giving an Absolute Origin diagnosis But rather probable!

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

Yes this was reported as in keeping with a metastatic, poorly differentiated, thyroid carcinoma (solid & insular patterns in these images). This was the lesion biopsied at presentation but there was a pT3 tumour in the thyroid. Well done all for considering a metastasis and particularly well done Nitin for considering thyroid.

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