Jump to content
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 1739 - 26 January - Dr Arti Bakshi Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

Clinical History: 53/F, 1cm firm dome shaped lesion on face ?BCC ?adnexal tumour.

Case Posted by Dr Arti Bakshi


  Report Record

User Feedback


Admin_Dermpath

Posted

Dr Arti Bakshi has a great case to tickle your brain cells.

 

Geoff Cross - DermpathPRO Projects

Share this comment


Link to comment
share_externally

Raul Perret

Posted

I would perform some more t cell markers to see if there is loss of expression and check for tcr rearrangement. But I thought of primary cutaneous cd4 positive small/medium cell lymphoma although they will change the name of this entity soon

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

T-cell rich B-cell Follicular Cell Lymphoma. K/Lambda to confirm.

I don't know if this is primary cutaneous. BCL2?

Share this comment


Link to comment
share_externally

Agree with Raul, I think this is best suited as the short-lived Primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoma.

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

I will call it also small/medium pleomorphic T cell lymphoma with this phenotype presented (it can show lots of reactive B cells), but only after performing TCR gene rearrangement and proving thst these T cells are monoclonal. 

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

I prefer SMPTCL with the L meaning "lymphoproliferation". I don't believe it's a lymphoma although I guess it's a grey zone lesion (literally and figuratively). If solitary probably harmless. If clinically multiple and progressive would probably be treated as a low-grade cutaneous lymphoma i.e. local radiotherapy I guess.

Share this comment


Link to comment
share_externally

Arti Bakshi

Posted

Well done all....this is small/medium pleomorphic T cell lymphoma or  'lymphoproliferation' as Richard would prefer it! Agree with all the comments made above regarding this entity. It was included as a provisional entity in the last EORTC and awaits final categorisation.

Further immunos showed PD1 positivity in the T cells, CD30 was negative and TCRPCR showed monoclonality. I put this case in, particularly to highlight that these cases can have quite a proportion of B cells, leading to confusion with B cell lymphomas. @Vincenzo, if its any consolation, our haematopathologist (with whom we share our cutaneous lymphoma cases) was also worried about a B cell lymphoma initially but came around to SMPTCL once the full immunopanel and history was at hand. The lesion was excised and no other lesions have since developed.

 

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

Great case, Arti, thanks. I was thinking of a B cell neoplasm because of many large CD20+ cells, but yes, this is a SMPTCL, I'm convinced now...

And I've better learned this entity. 

 

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...