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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 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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Alex-Ventura-Leon

Posted

What about Cutaneous Rosai Dorfmann?

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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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Eman El-Nabarawy

Posted

Solitary reticulohistiocytoma.

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vincenzo

Posted

XANTHOGRANULOMA JUVENILE. Too few plasma cells for RDD. 

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Leila Ahmed

Posted

What’s the final diagnosis?

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