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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 2558 - 27 April 2020 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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75M, Excision left upper arm. 2-4 year history lesion. Sore to touch. ?Granulomatous reaction.


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Atypical Intradermal Smouth Muscle Neoplasm.

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Eman El-Nabarawy

Posted

Atypical intradermal smouth muscle neoplasm.

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Dr. Mona Abdel-Halim

Posted

Yes, atypical intradermal smooth muscle neoplasm

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Meenakshi Batrani

Posted

Agree. Atypical intradermal smooth muscle tumor

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John Zhang

Posted

If the lesion is entirely confined to the dermis, then AISMT. But if it extends into the Dartos muscle layer, should we call this leiomyosarcoma? There is no subcutaneous fat in the scotum.

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Krishnakumar subramanian

Posted

Agree. Atypical intradermal smooth muscle tumor

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Admin_Dermpath

Posted

from Dr. Chaudhry - See below:


Dear All,

Thanks for some great comments and diagnoses. Below is my report:

Skin with fascicles of smooth muscle (Desmin+, SMA+) in the dermis with irregular borders. The lesional cells have fusiform cells with longitudinal striation, thin, cigar-shaped nuclei with blunt ends. There is a low mitotic index but moderate atypia. Coagulative tumor cell necrosis is not present. Proliferation index is 20 percent.

The features fall short of a diagnosis of leiomyosarcoma, however, the lesion is at least an atypical smooth muscle tumour.

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