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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.
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Case Number : Case 2768 - 15 February 2021 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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19M Right upper outer post thigh. 8/12 history enlarging punk lesion ? Spitzoid.


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Histiocytosis?

Need to perform IHC. to confirm or rule out melanocytic or vascular neoplasia.

Which IHC marker was applied in these pictures?

 

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Richard Logan

Posted

The fifth IHC with red counterstaining looks to be picking up the epidermal melanocytes, but is negative in the body of the lesion.  That and the overall silhouette suggest to me that this is not a melanocytic lesion.  The final IHC slide slide shows dermal dendritic cells which could be Langerhans' cells, so LHC is a possibility, although I don't see much sign of the classical reniform cytology or eosinophils.  There are prominent giant cells  with ground glass cytoplasm but I don't see emperipolesis.  Perhaps solitary reticulohistiocytoma should also be considered in the differential diagnosis.

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Dr. Richard Carr

Posted

I'd go for a solitary eruptive xanthogranuloma / histiocytoma.

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Leila Ahmed

Posted

I thought I saw emperipolesis. I’m favouring cutaneous Rosai Dorfmann too.

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XANTHOGRANULOMA JUVENILE. Too few plasma cells for RDD. 

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Admin_Dermpath

Posted

The final diagnosis was solitary eruptive xanthogranloma. Well done Richard :)

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