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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 1586 - 25 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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35 year old male with pigmented lesion on arm ?

Spot Diagnosis provided by Iskander Chaudhry


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Guest Romualdo

Posted

Wiesner nevus, to IHQ confirmation.

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Arti Bakshi

Posted

Deep penetrating naevus.

The cytomorphology of cells with plump oval to spindle cells with heavily pigmented macrophages would fit with this entity. Can see a few intranuclear inclusions too.These lesions may not always have deep extension.

Lack of maturation and some degree of cytological atypia is acceptable. Havent seen any mitoses and presuming there are none.

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Raul Perret

Posted

This is a compound benign, superficial, wedge shaped and symmetrical lesion. It has a dermal component that tends to be arranged in a plexiform fashion. On my eyes there is a dual cytological component: dendritic cells (last image) and banal nevocytes that in areas surround adnexae. I agree with Arti, it fits in the blue nevus category: Superficial deep penetrating nevus, I think we could also discuss a combined nevus (phenotypic heterogeneity) with banal and blue nevus components. However this discussion would be pointless as there is no difference in prognosis and the entities share many morphological features.

I did not think of Wiesner nevus, as this is frequently a dermal based lesion (although probably this is not an exclusive parameter) and to my knowledge the presence of a component of dendritic melanocytes is not a feature.  

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vincenzo polizzi

Posted

It's a nevus!!! Not a BAP1-negative cells nevus. Not an atypical Spitz Nevus. Not a melanoma!!! Nevus it is, so I agree with all of you.

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Nitin Khirwadkar

Posted

Deep penetrating naevus/naevus with phenotypic heterogeneity. Favour DPN.

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vincenzo polizzi

Posted

I have review more carefully the images, and agree with Romualdo... 

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Iskander H. Chaudhry

Posted

Thank you all! 

 
It was diagnosed as a deep penetrating naevus. 

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