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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 2093 - 14 June 2018 Posted By: Raul Perret

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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42 year old male with a superficial mass localized on the buttock


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After ruling out hhv8  favour aneurysmal fibrous histiocytoma

 

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Anil Patki

Posted

Angiomatoid fibrous histiocytoma

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Raul Perret

Posted

Yes, this is a classical case of aneurysmal dermatofibroma. The presence of collagen entrapment at the periphery of the tumor (last pic) is a good clue for the diagnosis of this neoplasm. Although diagnosis of dermatofibroma and its variants should be based on morphological grounds, HMGA2 expression is frequently seen in this group of tumors. Regarding the differential with angiomatoid fibrous histiocytoma, the absence of a prominent peripheral lymphocytic inflammatory component (usually forming primary and secondary follicles) and the collagen entrapment are good features for ruling it out. In addition, AFH shows desmin expression in 50% of cases and has a rearrangement of EWSR1.

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