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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 2106 - 3 July 2018 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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48 year old man with subconjunctival right eye lesion, fleshy and solid.

Edited by Admin_Dermpath


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Difficult case. I can’t even tell whether it’s infectious or neoplastic. There are some foamy macrophages that appear to contain something in the cytoplasm. The other cells are maybe lymphocytes. For now , I would like to do AFB, GMS, and Gram stains. Reminding me of Rhinoscleroma ( but it’s not in the nose). Any risk for immunocompromised conditions. Atypical mycobacterium?

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dermpath1

Posted

Adding xanthogranuloma  and sebaceus neoplasm to the DDX.

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Uma Sundram

Posted

Great points from all! Thank you. Immunocompetent patient and all special stains negative for micro organisms.

Fleshy solitary lesion on the conjunctiva of the eye (rather than on the lid). CK7 negative. We thought it was an adult xanthogranuloma. Lymphoma work up negative.

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vincenzo

Posted

Also thought of an adult xanthogranuloma, after some minutes around Chalazion, but agree wit XG.

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