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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 1764 - 2 March - Dr Arti Bakshi 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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Clinical History: Scalp lesion.

Case Posted by Dr Arti Bakshi


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Admin_Dermpath

Posted

Thursdays wouldn't be the same without the latest Spot Diagnosis Case from Dr Arti Bakshi.

 

Geoff Cross - DermpathPRO Projects

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vincenzo polizzi

Posted

The solar damaged skin, sclerosing deep dermis and lymphoid nodular peripheral reaction could make think of a desmoplastic melanoma, but silhouette looks like symmetrical and there isn't too much nuclear atypia...so Desmoplastic Neurotized Nevus is my first thought. 

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Alice Roberts

Posted

Concerning for desmplastic melanoma but not marked atypical. I would do S100 to confirm and SMA to rule out smooth muscle neoplasm, and ki67.  Depending on clinical and results of IHC, would go from there.

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Dr. Mona Abdel-Halim

Posted

I have the same thoughts, desmoplastic nevus, less likely desmoplstic melanoma

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Robledo F. Rocha

Posted

Exercising the spot diagnosis, I favor desmoplastic melanoma. Site, assumed old age of the patient (taking into account the solar elastosis evidenced on low power view), impaired maturation, some nuclear pleomorphism, and lymphoplasmacytic aggregates are the findings that formed my opinion. Lesion was incompletely excised, so other characteristics cannot be accessed, including size, circumscription, neurotropism, and deep infiltration.

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Raul Perret

Posted

I also thought of desmoplastic melanoma

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Josie Bisi

Posted

I agree desmoplastic nevus x desmoplastic melanoma.

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Nitin Khirwadkar

Posted

Scar -like dermal proliferation with random atypia, scattered lymphoid aggregates and plasma cells. I think this is a desmoplastic melanoma.

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Arti Bakshi

Posted

This is an incisional bx from a 1cm lesion on the scalp of a 80 year old man. S100 was diffusely positive and Melan A was negative. Agree that atypia is subtle, but given the clinical context, went for a Desmoplastic Melanoma too.

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