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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 2871 - 08 July 2021 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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18F punch biopsy left shin. 2-year-history ?Bowen’s ?angioma


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vincenzo

Posted

No high grade atypia. One dermal mitosis, typical.  No expansive mass-forming intradermal growth. Not important pagetoid epidermal spreading. Kamino’s bodies. My spot is Spitz nevus, angiomatoid type. 

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Eman El-Nabarawy

Posted

Traumatized Spitz nevus.

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Alex-Ventura-Leon

Posted

Agree. Traumatized Spitz Nevus. 

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volha

Posted

Spitz nevus 

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Saleem Taibjee

Posted

Yes, well done. I also favoured traumatised, but benign, Spitz naevus. There were nice Kamino bodies. But these are difficult cases, and to illustrate this, when I did share this case with an experienced pathologist he had favoured melanoma (but I disagreed). After hearing his opinion I thought it would be worthwhile pursuing the case with some immunohistochemistry. In particular, BRAFV600E was negative, but interestingly NTRK positive (see below). The latter suggests that this is a Spitz underpinned by a NTRK fusion pathway, but of course this does not in itself indicate a benign diagnosis because NTRK has been reported in the whole spectrum of Spitz tumours. Even so, an immuno panel of BRAFV600E and ALK / NTRK / ROS-1 can sometimes be helpful in distinguishing 'spitzoid' superficial spreading melanoma from a true Spitz lineage, as in this case.

BW
Saleem

24939_10.0x NTRK labelled.jpg24939_10.0x BRAFV600E labelled.jpg24939_10.0x p16 labelled.jpg

 

24939_10.0x Ki67 labelled.jpg

 

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HENRY

Posted

beautiful stains. I love the NTRK stain. thanks for sharing.

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