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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2098 - 21 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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71 year old male with a 37 mm superficial tumor localized to the back.

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Alice Roberts


Spindle cell/ pleomorphic lipoma (can be quite myxoid)

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Raul Perret

Posted (edited)

Yes well done everyone. This was a case of spindle cell lipoma "fat poor". CD34 was diffusely positive, and RB1 and s100 were negative. I always perform this IHC panel because distinguishing myxoid neurofibroma from spindle cell lipoma only based on HE can be virtually impossible in a subset of cases. Spindle cell lipoma consists of a proliferation of spindle cells with delicate, non-atypical round to oval nuclei surrounded by a myxoid stroma with the presence of ropey collagen,  mast cells and mature fat tissue (can be absent in some cases)

Edited by Raul Perret

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