Jump to content
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 2271 - 26 February 2019 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

33 year old male with thigh lesion


  Report Record

User Feedback


Krishnakumar subramanian

Posted

can we have HHV8 status , before we call it hobnail hemangioma

Share this comment


Link to comment
share_externally

Alex-Ventura-Leon

Posted

Hobnail hemangioma was my first thought, but i dont like the deeper compound so i would perform HHV8 to rule out Kaposi Sarcoma

Share this comment


Link to comment
share_externally

vincenzo

Posted (edited)

Let me justify my diagnosis of hobnail hemangioma. The deep areas hold an interstitial spindle cell proliferation between the bundles of collagen, that surround preexisting vascular spaces in a Kaposi-like promontory sign manner. But this should be a plaque stage of Kaposi, so we should find a more fascicular infiltrative pattern; and, mostly, in Kaposi there isn't(usually) any zonation. However I agree with above. Without HHV8 I wouldn't do a diagnosis of hobnail hemangioma, in real life, of course.

Edited by vincenzo

Share this comment


Link to comment
share_externally

Uma Sundram

Posted

Thank you all for your insightful comments, especially those who i know look at this site daily. We are so appreciate of your support!

Yes, hobnail hemangioma. HHV8 is negative.

My interest in posting this case is its overlap with angiosarcoma in terms of architecture. A smaller biopsy would have made it difficult to completely exclude a well differentiated angiosarcoma. You may remember my prior post about the clinical scenarios for angiosarcoma (old person head and neck, post radiation (breast especially), stewart treves, arteriovenous fistula).

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...