Case Number : Case 2080 - 28 May 2018 Posted By: Limin Yu

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.

Desmoplastic melanoma. 

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.

I thought of neoplasm too. AFX?

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

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.