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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 Number : Case 1910- 22 Sept - Dr Iskander Chaudhry 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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85 year old. Short history of nodular tumourous lesions appearing on lower legs. Left thigh incisional biopsy

Edited by Admin_Dermpath


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urmilapandey

Posted (edited)

agree and would also include a myeloma in the differential

Edited by urmilapandey

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Nitin Khirwadkar

Posted

Agree with the differentials above. Needs IHC.

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Sasi Attili

Posted

3 hours ago, Raul Perret said:

Lymphoma plasmablastic vs PCDLBL leg type

agree

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vincenzo polizzi

Posted

Yes it’s a plasmacytic/plasmablastic family’s member, but I think this should be an extramedullary manifestation of plasmablastic myeloma rather then a plasmablastic lymphoma... or an extramedullary plasmocytoma.  

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Admin_Dermpath

Posted

The tumour is negative for T and B cell markers .... Iskander Chaudhry 

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Raul Perret

Posted (edited)

CD138, Ki67, EBER?

Edited by Raul Perret

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vincenzo polizzi

Posted

...in keeping with plasmocytoma/myeloma (BCL2? CD138? CD38? CD56?)

plasmablastic lymphoma usually shows similar immunophenotype, but I don’t find the typical macronucleolus of plasmablastic ly. But these are spot observations of course.  

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Admin_Dermpath

Posted

Hi All 

The lesional cells are:

Positive for: CD45, CD43, CD138, CD56 (patchy), Kappa light chain restriction (mRNA)

Negative for: CD3, CD5, CD20, Pax5. 

Ki67 - high proliferation 

Your final diagnosis is: ........

 

Iskander

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Raul Perret

Posted

Link without CPC and EBER I would be extremely cautious before rendering a definitive diagnosis

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Dr. Mona Abdel-Halim

Posted

Agree

plasmablastic lymphoma vs. Plasmacytoma/myeloma

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Dr. Mona Abdel-Halim

Posted

1 hour ago, Raul Perret said:

Link without CPC and EBER I would be extremely cautious before rendering a definitive diagnosis

Nice article, thanks Raul.

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Admin_Dermpath

Posted

Thanks everyone!

 

Great discussion!! 

 

So patient has history of myeloma; HIV negative, EBER negative

 

Our final diagnosis was: 

 

Plasmablastic plasma cell myeloma

 

 

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