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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.
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Case Number : Case 1877 - 08 August - Dr Diwan 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 hospitalized patient status post chemotherapy, with lung infiltrates, neutropenia and numerous erythematous papular nodules on trunk and extremities. This biopsy is from the left arm. (Images courtesy of Dr. Heather Barker.)


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Raul Perret

Posted

Hematological malignancy, leukemia cutis?

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Dr. Mona Abdel-Halim

Posted

Hematolymphoid infiltrates for complete IHC. Can not predict anything from morphology actually. 

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vincenzo polizzi

Posted

Lymphomatoid granulomatosis (for cpc of course!!!)

The infiltrate seems angiocentric, and some cells are larger (EBV+ B-cells) then others (reactive T-cells), but it's a lot difficult with these photos...

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Dr. Hafeez Diwan

Posted

Leukemia cutis.  Patient has AML.  MPO is positive.

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Saman Fatah

Posted

This dermal infiltrate is predominantly perivascular mononuclear cellular infiltrate with stands of single cells between the collagen bundles. There is subtle pallor of papillary dermis but no convincing oedema. MPO will stain the premature granulocytes and I wounder how this infiltrate is different from "Histiocytoid" Sweet's Syndrome? AML is one of well known Haematological malignancies associates with SS (besides MDS and others). The clinical context and sometimes only a period of observation can clarify this distinction. 

Iam grateful if any Dermatopathologist colleague can educate me if such distinction is possible on histology/IHC?

Classical SS is diffuse dense band like but predominant perivascular distribution can be seen (probably depending on the age and morphology of the lesion biopsied).

Thanks

 

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Anil Patki

Posted

Another feature seen in this slide is hyalinization of collagen. Is this seen only in this malignancy? Pubmed search for hyalinization of collagen by malignant cells shows no results

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