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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 2201 - 15 November 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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Male 85y, 19 mm nodule located in the face (nasolabial fold).


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Alex-Ventura-Leon

Posted

My spot is Spindle Cell Lipoma. But, im gonna need a CD34 and MUC4 to confirm because the location its quite odd.

 

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Agree with spindle cell lipoma. Yes, the location is a little bit odd. If it's on the shoulder or back, I would sign out as spindle cell lipoma without any immunohistochemical studies. But since the location is odd and it's a little bit more superficial, I would add Desmin and ER to CD34 because it's very difficult to distinguish spindle cell lipoma from mammary-type myofibroblastoma based purely on morphology, although they may be related genetically because they both show loss RB1, I think. But I don't do molecular so I don't really know.

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Alex-Ventura-Leon

Posted

Sorry. I don't know why I wrote MUC4.

Its CD34 and RB1 as Anh mentioned. 

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Raul Perret

Posted

Yes my diagnosis was spindle cell lipoma but explained that there was a morphological overlap with mammary type myofibroblastoma. Desmin was not expressed which is less in favour of mammary type myofibroblastoma. Nevertheless,  both of these tumors and cellular angiofibroma are closely related.

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