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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 2283 - 14 March 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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67y old male with a superficial lesion located in the back of the neck


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Alex-Ventura-Leon

Posted

Hamartomatous lesion composed of: fat, collagen, smooth muscle, nerves and lymphatic vessel (i think).

I dont have a name for this lesion so im waiting for more comments to learn

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The spindle cell lipoma often shows a pseudoangiomatous pattern...in this case you can see branching cavernous spaces, lined by flattened endothelial cells and villiform fibrolipomatous projections. Difficult for me, but I'm thinking of a pseudoangiomatous variant of Spindle Cell Lipoma.

 

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Alex-Ventura-Leon

Posted

Spindle Cell Lipoma cross my mind but i didn´t know that could look with this pattern, thanks Vincenzo, its a good differential

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Raul Perret

Posted

I called this a vascular malformation (mainly venous) with thrombosis and secondary papillary endothelial hyperplasia. The lesion was mainly located in the hypodermis that is why we see so much fat. The presence of dystrophic blood vessel and nerve bundles within the lesion is a good tip pointing towards a malformative vascular lesion (reference)

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On 15/03/2019 at 13:52, Raul Perret said:

I called this a vascular malformation (mainly venous) with thrombosis and secondary papillary endothelial hyperplasia. The lesion was mainly located in the hypodermis that is why we see so much fat. The presence of dystrophic blood vessel and nerve bundles within the lesion is a good tip pointing towards a malformative vascular lesion (reference)

thanks for sharing! 

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