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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 2328 - 20 May 2019 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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68, scrotum


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Krishnakumar subramanian

Posted (edited)

pagetoid Bowens disease  since CK 7 positive

DD

Paget;s disease

Melanoma in situ

IHC markers 

Pagetoid BD is negative for CK 18, CK 20, CEA, and Sox 10

Edited by Krishnakumar subramanian
differential diagnosis added

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Alex-Ventura-Leon

Posted

Agree. Need more IHQ but for now, I favor Pagetoid Bowen Disease.

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IgorSC

Posted

I think histology with signet ring-like cells, pale cytoplasma and aparent glandular differentiation are consistent with Extramammary Paget disease. Workup for visceral malignancy is needed.

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vincenzo

Posted

Agree with Igor. Pagetoid atypical cellular spreading of mucinous/glandular cells. Any visceral malignancy?

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Dr. Mona Abdel-Halim

Posted

I can see beautiful eyeliner sign and glandular differentiation. I believe this is EMPD and will do CK20 to in addition to extensive workup to exclude secondary EMPD.

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