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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 2640 - 19 August 2020 Posted By: Dr. Hafeez Diwan

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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34 year old female with inguinal lymph node biopsy. She also has a perianal lesion at the anal verge extending to labia.


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Krishnakumar subramanian

Posted

granulomatous inflammation some what emperipolesis seen if i am not mistaken

can we have macrophage markers and s 100

 

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Agree. I would also add IHC for Treponema pallidum

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Meenakshi Batrani

Posted

The pale nodule appears epithelioid to me. Could it be a metastatic deposit. 

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Dr. Hafeez Diwan

Posted

Many of the plump cells are juicy endothelial cells.  There are also plasma cells.  The treponema IHC was very positive. The perianal lesion referred to in the history was also positive for spirochete.  So this was syphilis involving the lymph node.

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Krishnakumar subramanian

Posted

Thanks a lot Dr

Basic rule whenever there are plasma cells get serology done

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