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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 2080 - 28 May 2018 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Lesion of a 60 year old woman, forehead


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Anil Patki

Posted

A polymorphous infiltrate in the dermis with lympocytes and epithelioid cells. Grenz zone is seen. Two conditions come to my mind- viz granulomatous rosacea and granuloma faciale. Clinico- pathological correlation is required.

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vincenzo polizzi

Posted

Desmoplastic melanoma. 

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Agree with desmoplastic melanoma if the lesion is positive for melanocytic markers. If not, then need a cytokeratin to rule out a primary carcinoma or a met.

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Raul Perret

Posted

I thought of neoplasm too. AFX?

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Dr. Richard Carr

Posted

I can't place this tumour easily. Would need some brown stains. I wonder about a known primary elsewhere?

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Limin Yu

Posted

Thanks for the insightful discussion.  This is one of those cases that images don't deliver a good representation of the HE slide.  

 

It's a predominantly dermal proliferation of epithelioid melanocytes. Fair amount of pleomorphism is seen.  FISH studies showed no copy number alterations on Chromsomes 6, 9 and 11. 

 

It was signed out as atypical spitzoid tumor, a borderline entity in the spectrum of Spitzoid neoplasm. 

 

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