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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 2688 - 26 October 2020 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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64M, Left lower back excision. ? Naevus


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Richard Logan

Posted

Epithelioid haemangioma (angiolymphoid hyperplasia with one eosinophil!).

What are the ganglion-like cells?

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Eman El-Nabarawy

Posted

Angiomatoid/ desmoplastic Spitz nevus.

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Totally agree with Victor and Eman...but this case is difficult, because of:

1) pz age

2) lymphocytic infiltrate, usually found in DMM ( but also found in DSN ). 

In short, my spot is Desmoplastic ( H-RAS? ) Spitz Nevus. 

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Krishnakumar subramanian

Posted

which is better S100 or Sox 10 sir

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Richard Logan

Posted

Iskander, what was the final diagnosis please?

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Iskander H. Chaudhry

Posted

Dear All 

Please see my comments:

Skin with a non-ulcerated symmetrical intradermal melanocytic lesion. The dermal nests are
composed of epithelioid cells with large nuclei, small nucleoli and abundant cytoplasm. The
epidermis is mildly acanthotic. The dermal component shows maturation with depth and prominent
fibrosis around the dermal nests. No mitoses are seen. The proliferation index is low.


The features are those of a desmoplastic Spitz naevus and given the age of the patient this lesion is
considered atypical and MDT discussion is advised.

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Dr. Richard Carr

Posted

typical desmoplastic Spitz naevus at and uncommon age.

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