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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 1650 - 21 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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Clinical Details: F50. Back. ?Epidermoid cyst.

Case Posted by Dr Richard A Carr


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Admin_Dermpath

Posted

Another beautiful case from Dr Richard A Carr to round off the week.

 

Cheers, Geoff

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Dr. Mona Abdel-Halim

Posted

Spiradenocylindroma maybe better than just spiradenoma !

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Raul Perret

Posted

Richard, you showed this case to Dr. Kazakov when we were in Pilsen right?

 

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Spiradenoma (maybe spiradenocylindroma) with too much tubular differentiation

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Eman El-Nabarawy

Posted

Spiradenoma with excessive hyaline deposits and duct all differentiation.

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vincenzo polizzi

Posted

I see only myoepithelial-like cells with cylindromatous arrangement...but sincerely I don't know what it is! Waiting for the diagnosis.

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vincenzo polizzi

Posted

...and I see thymoma- like lymphocytes rich perivascular spaces but... again I'm waiting for the diagnosis. 

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Dr. Richard Carr

Posted

Both Raul and Nitin are correct they have seen the case in Pilsen and Warwick respectfully - I suspect this is a reflection of how dermpathpro is making connections across the planet! Vincenzo - you are quite correct - there are no tubules visible in these images - at least I could not see them on H&E.

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Arti Bakshi

Posted

There is a prominent cribriform pattern with pseudo cysts containing mucinous material. Other areas more typically spiradenomatous.

Maybe a spiradenoma with 'adenoid cystic Ca' like areas. 

(Cant enlarge images...is that a problem others are facing too?)

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Dr. Richard Carr

Posted

Yes well done all, and especially Arti, this is a spiradenoma with adenoid cystic carcinoma-like areas.  It was extremely pauci-luminal (even on BerEP4 only very sparse weak central ductal cells but no clear cut lumina). Case also seen by Dmitry Kazakov in Pilsen who thought it was a benign lesion.

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