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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 2925 - 22 September 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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46F, excision left upper thigh ?amelanotic melanoma ?BCC ?Spitz ?BAPoma


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Victor Delgado

Posted

Neural vs. Myofibroblastic tumor, may be hyalinized myofibroma? Dermal Nodular Fascitis?

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vincenzo

Posted

Epithelioid Fibrous Histiocytoma. ALK? Typical hyalinized stroma of older lesions and typical epidermal collarette

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Anil Patki

Posted

There are cellular and myxoid zones with spindle cells vaguely showing nested or whorled pattern. I think that this will require a battery of IHC stains. Mixed type of neurothekeoma comes to my mind.

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Meenakshi Batrani

Posted

Could this be a newly described spindle cell variant of epithelioid cell histiocytoma (spindle cell histiocytoma). IHC is needed. 

 

Kazlouskaya V, Ho J, Jedrych J, Karunamurthy A. Spindle cell variant of epithelioid cell histiocytoma (spindle cell histiocytoma) with ALK gene fusions: Cases series and review of the literature. J Cutan Pathol. 2021 Jul;48(7):837-841

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Saleem Taibjee

Posted

Yes, absolutely spot on ... this is epithelioid fibrous histiocytoma, and I think could be justifiably deemed an example of the spindle cell variant. The ALK immunostain (positive) is shown below. There are frequently misdiagnosed as haemangiomas or melanocytic lesions clinically. The thigh seems to be a common anatomical site.

BW Saleem

10921_10.0x ALK.jpg10921_20.0x ALK.jpg

 

 

10921_2.5x ALK.jpg

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