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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 1642 - 11 October 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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63 year old woman with red nodule on center chest.

Case Posted by Dr Uma Sundram


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vincenzo polizzi

Posted

Cutaneous B peripheral cells marginal zone lymphoma 

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Nitin Khirwadkar

Posted

Agree. Dermal nodule with small, monocytoid cells. 

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Raul Perret

Posted

23 minutes ago, arti bakshi said:

Needs immunos....

agree

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Uma Sundram

Posted

Super! I think all comments point to the most important differential diagnosis, namely marginal zone lymphoma and chronic lymphocytic leukemia (secondary involvement of skin). The lesional cells are CD79a+CD5+CD43+CD23+, supportive of CLL. Years ago, we published a paper looking at CLL vs MZL and found significant histologic overlap, as well as light chain restriction in both entities. PC MZL does not express CD5, which helps confirm the diagnosis of CLL.

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