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 1919 - 06 Oct 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)

History: 45/F, lesion left antecubital fossa


  Report Record

User Feedback


Anil Patki

Posted

"Tissue culture" of fibroblasts - ? Nodular fasciitis

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

Multinodular growth pattern. Slit like vessels separating nodules. There aren’t cellular and sclerotic alternating areas, but I think this is a paucicellular hyalinized variant ( or stage ) of Fibroma of tendon sheath. 

Share this comment


Link to comment
share_externally

urmilapandey

Posted

would add desmoplastic fibroblastoma to the differentials mentioned above

Share this comment


Link to comment
share_externally

I like the idea of desmoplastic fibroblastoma. What about beta-catenin immunostain?

Share this comment


Link to comment
share_externally

Anil Patki

Posted

Desmoplastic fibroblastoma shows thick, hyalinized bands of collagen like in a keloid which are not seen here

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

Where's Raul et al when we need them!  I was thinking nodular fasciitis so glad to see Mona on same ticket!

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

Actually think it might prove to be neurofibroma - plexiform/myxoid and last image shows somewhat distinctive collagen tracts - almost can imagine the axons. S100 please (if negative stick with first spot).

Share this comment


Link to comment
share_externally

Raul Perret

Posted

rather difficult based only on these images. Thought of neurofibroma mainly but all the differentials are valid. s-100, EMA, SMA, Desmin, CD34?

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

I’m still thinking of a TSF. But it could be also a hyalinized variant/stage of myofibroma ( without hemangiopericytomatous areas).  

Share this comment


Link to comment
share_externally

Arti Bakshi

Posted

I am no expert on soft tissue tumours, but i can tell you the immunohistochemical panel. S100, SMA, desmin, CD34 and EMA were all completely negative. So that ruled out neurofibroma and myofibroma. I would have expected some SMA positivity in nodular fasciitis, so did not go for that either. 

I actually left it as a differential of Fibroma of Tendon Sheath and Desmoplastic Fibroblastoma.

I dont think the lesion fits neatly into either, but that's often the frustration with soft tissue lesions! Thanks for all your comments and any further suggestions given the IHC are welcome.

 

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...