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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 2501 - 06 February 2020 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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65M, longstanding skin-coloured nodular lesion left lateral nose ?fibrous nodule ?fibroadenoma


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Amiloidosis. I think hematological study should be important!!! ( ?Waldenstrom )

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Nodular amyloidosis. Plasma cells are common and the amyloid is derived from light chain immunoglobulin.

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Dr. Mona Abdel-Halim

Posted

Yes, nodular amyloidosis. Lovely case!

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Eman El-Nabarawy

Posted

Agree with nodular amyloidosis. Nice plasma cells clue.

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Saleem Taibjee

Posted

Yes, well done. This is surely nodular amyloidosis. Nose is a good location for this primary nodular form, I've seen it twice before in this location. However, it is still mandatory to request/exclude a serum paraprotein.

As Eman points out, the plasma cells are a vital clue. Below is the Kappa and Lambda. This confirms Lambda restriction, which indirectly confirms the diagnosis. Congo Red also below.

BW

Saleem

50488_20.0x Lambda labelled.jpg

 

50488_20.0x Kappa labelled.jpg

50488_10.0x Congo red repeat.jpg

50488_20.0x Lambda.jpg

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