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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 2824- 4 May 2021 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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80 year old male with fore arm lesion.


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msofopoulos

Posted

Absence of umbrella sign in an 80year old with sun damaged skin, i think its a Melanoma. I cant figure out the in-cohesive scatter.

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Meenakshi Batrani

Posted

Lentigo malligna melanoma. The invasive component seems to be desmoplastic but there are some epithelioid cells as well- so may a mixed type if not pure desmoplastic. There is also perineural invasion. 

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Richard Logan

Posted

Very nice demonstration of a "negative umbrella sign" suggesting a lesion of recent onset.  Also beautiful example of perineural invasion on H+E and MART1. Agree that the pattern of the invasive component is unusual - the forearm is not a common site for desmoplastic melanoma.

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Uma Sundram

Posted

Yes, it's an amazing case of invasive melanoma, mixed type. Perineural invasion highlighted by MART 1.

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Invasive melanoma with perineural invasion 

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