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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 1559 - 16 June 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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38 year-old male with biopsy midline perianal mass.

Dr Hafeez Diwan


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vincenzo polizzi

Posted

?Perianal Primary Chancre   ?Crohn Disease? It seems there are many plump endothelial cells between the dense plasma cell infiltrate, and some subtle granuloma that point more to primary syphilis...

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biswanath behera

Posted

Decapitation, plasma cells. thinking of syringocystadenoma papilliferum

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Raul Perret

Posted

I agree that syphilis should be discarded in a case like this, there is some epidermal hyperplasia massive presence of plasma cells, etc. Spirochete staining is a must, I think it will be positive. Syringocystadenoma papiliferum also crossed my mind but is not the typical image (the papiliferum part is not present and the plasma cells are surrounding the lesion) and epithelium looks reactive maybe because of the inflammatory infiltrate. But agree with the three excellent differentials of the colleges.

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Dr. Hafeez Diwan

Posted

I called it a median raphe cyst.

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