Case Number : Case 1846 - 26 June - Dr Limin Yu Posted By: Guest

Dr Limin Yu has a great case for you in his last posting of this month.

Geoff Cross - DermpathPRO Projects

Giant cell collagenoma (GCC) .The differentials include multinucleate cell angiohistiocytoma , circumscribed storiform collagenoma, pleomorphic fibroma, regressive forms of dermatofibroma, and solitary myofibroma .

If we agree that the giant cells seen are of the floret-type, then we may say that these cells can be seen in skin pathology in some conditions such as  pleomorphic lipoma,  giant cell fibroblastoma , neurofibroma, giant cell angiofibroma and giant cell collagenoma.

The last 3 conditions might be pertinent to this particular case.

Pleomorphic fibroma of the skin. A spindle cell tumor showing multinucleated giant cells that have large pleomorphic and hyperchromatic nuclei, within a dense collagenous background.

Giant cell collagenoma

I think this could be an example of fibrous papule of the nose, pleomorphic/giant cell variant.

28 minutes ago, vincenzo polizzi said:

I think this could be an example of fibrous papule of the nose, pleomorphic/giant cell variant.

Good suggestion :-)

Pleomorphic Fibroma

For me this is more consistent with pleomorphic fibroma but I would not mind if someone called this pleomorphic variant of fibrous papule of the nose

Thank everyone for your profound insights!

This is a FP to me. It's more sclerotic than what's typically seen. That's why I thought it would be a good case to share. 

Pleomorphic fibroma is a ddx to consider.  The reason I did not go this route is because the atypical cells in this case are not too atypical. I understand this is subtle and the difference is only in the eyes of beholders. 

Thank everyone for your time and discussion.