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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 2303 - 11 April 2019 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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Abdomen lesion, 50 year old male


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Diffuse neurofibroma rule out desmoplastic melanoma

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John Zhang

Posted

Agree with these considerations. I would definitely first run S100 to rule out a melanocytic or a neural lesion. Neurofibromas can have fat metaplasia. In the high power views there doesn't seem to be substantial nuclear atypia, therefore I doubt it's a demoplastic melanoma. If S100 is negative then then consider spindle cell lipoma or DFSP. Would also run CD34.

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Krishnakumar subramanian

Posted

 

spindle cell tumor from dermis and infiltrating into fat tissue

looks bland

shall do s 100 and Sox 10 and Cd34

if sox 10 negative, but s 100 positive, Cd 34 negative- a list of tumors like NF/

if sox 10 negative s100 and Cd 34 positive- fusion transcript driven tumors

only cd 34 could be DFSP but will look for fusion transcripts as bland cellular pattern sir

 

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DFSP, sclerosing variant, with some Giant Cell Fibroblastoma-like features, as perivascular lymphocytes.  

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Alex-Ventura-Leon

Posted

Agree with the differentials, I favor DFSP but we need inmunos for sure.

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Raul Perret

Posted

Yes, DFSP. COL1A1-PDGFB fusion was detected by FISH. The tumor was a bit inflammatory a finding that is rare in this neoplasm

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Alex-Ventura-Leon

Posted

Great case Raul. Would you please give us the final answer of Case 2298 - 4 April 2019.

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Raul Perret

Posted

On 12/04/2019 at 19:19, Alex-Ventura-Leon said:

Great case Raul. Would you please give us the final answer of Case 2298 - 4 April 2019.

Done, sorry for the delay 

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