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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2426- 17 October 2019 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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70F, excision lesion cheek

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Saleem Taibjee


The first immuno shown yesterday was BerEP4.

The other immunos showed:

CD56 and chromogranin patchy positive, whereas negative staining for EMA, synaptophysin, CK20, TTF-1, CK7. Cam5.2 weak patchy membranous only.

This is a nice example of BCC with neuroendocrine differentation, with more typical BCC highlighted at the periphery, more 'high grade' centrally. The limited literature indicates that BCC with neuroendocrine differentation has an excellent prognosis i.e. no metastatic potential.

09303_10.0x CD56.jpg

09303_10.0x chromogranin.jpg

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Krishnakumar subramanian


Good learning points, thanks Dr

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I was off the road...thinking about a salivary gland adenocarcinoma, NOS. 

Thanks for this case.

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