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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 1810 - 05 May - Dr Richard A Carr Posted By: Guest

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Clinical History: F10. Leg. ?Mole.

Case Posted by Dr Richard A Carr

Edited by Admin_Dermpath


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Guest Asmara syed

Posted

congenital nevus

 

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Mariantonieta Tirado

Posted

Benign vascular lesion. Possibly Multinucleated cell angiohistiocytoma; though this patient a little young for this diagnosis.

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Raul Perret

Posted

I would do a small panel of immunos here including CD34. I did consider strongly multinucleate cell angiohistiocytoma but the clinical setting looks weird and there seems to be some pseudovascular spaces too. My differential includes MCA vs dermatofibroma (although some pathologists consider MCA a variant of DF) and finally but unlikely giant cell fibroblastoma. 

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Fernando Cabo

Posted

Multinucleate cell angiohystiocitoma

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vincenzo polizzi

Posted

I though a lot of an odd dermal variant of GCF, but changed my impression. Favour an angiectatic /hemosiderotic dermatofibroma. 

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Nitin Khirwadkar

Posted

The epidermal changes in this case are for a dermatofibroma. Agree, has got changes seen with a MCA. Odd location for the latter.

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Robledo F. Rocha

Posted

The clinical suspicion of a mole gives me the impression this was a pigmented papule. Microscopic features include epidermal hyperplasia with flattened rete ridges and hyperpigmented basal layer overlying a intradermal poorly circumscribed proliferation of thin-walled ectatic vessels, spindle cells and some multinucleated cells with hemosiderin deposition and peripheral collagen entrapment. Adding clinical and microscopic findings, I favor one of the many variants of dermatofibroma.

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Dr. Mona Abdel-Halim

Posted

DF (aneurysmal fibrous histiocytoma)

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vincenzo polizzi

Posted

The take home msg is: epidermal changes above a dermal fibrovascular lesion is a clue to DF.  Isn'it?

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Raul Perret

Posted

After new images dx is aneurysmal fibrous histiocytoma

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nick turnbull

Posted

Kia ora. From far away it looks a bit worrying but on closer inspection we see it's full of holes. Is it the lions defensive line? On second  inspection I was thinking this is an anurysmal Df. 

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Arti Bakshi

Posted

There are some very 'giant cell fibroblastoma' like areas, particularly in the initial images. Would do a CD34 to rule out GCF/DFSP overlap. If negative, agree with aneurysmal FH.

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Dr. Richard Carr

Posted

Great discussion. I went for fairly typical cellular DF (aneurysmal included in this) with giant cell angiohistiocytoma-like areas (may even be a collision with a haemangioma or perhaps the DF produces haemangioma-like appearances in one type / stage of involution). I don't think I did any immunos.

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Sasi Attili

Posted

A bit late- but thought this was an aneurysmal DF...

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