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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 3023 - 7 February 2022 Posted By: Dr. Mona Abdel-Halim

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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38F, Progressively enlarging hyperpigmented focally atrophic multi-nodular plaque on the left breast


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Richard Logan

Posted

Dermatofibrosarcoma protruberans.  The cytology is rather bland, but the clinical description, depth of penetration and CD34 positivity clinch the diagnosis.

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Krishnakumar subramanian

Posted

agree for DFSP

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Meenakshi Batrani

Posted

Agree with DFSP

 

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vincenzo

Posted

I saw this case on my cpt ( first spot on iPhone ). Not sure about DFSP. The cellular features are more in keeping with DF.  

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Richard Logan

Posted

15 hours ago, vincenzo said:

I saw this case on my cpt ( first spot on iPhone ). Not sure about DFSP. The cellular features are more in keeping with DF.  

I agree, the cytology that we are shown is not very worrying.  However, we can only see the upper part of the tumour.  Very often in DFSP, the deeper part of the tumour shows much more abnormal cellular features.

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vincenzo

Posted

8 hours ago, Richard Logan said:

I agree, the cytology that we are shown is not very worrying.  However, we can only see the upper part of the tumour.  Very often in DFSP, the deeper part of the tumour shows much more abnormal cellular features.

Agree. However The cells show a clear, maybe foamy cytoplasm, histiocytic-like, more in keeping with DF. CD34 positivity could be a misleading sign. Waiting for final comments. 

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Richard Logan

Posted

15 hours ago, vincenzo said:

Agree. However The cells show a clear, maybe foamy cytoplasm, histiocytic-like, more in keeping with DF. CD34 positivity could be a misleading sign. Waiting for final comments. 

I am pushed to a diagnosis of DFSP by the characteristic and paradoxical combination of atrophy and nodularity.  I wouldn’t expect those in a dermatofibroma.

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Dr. Mona Abdel-Halim

Posted

This biopsy was diagnosed as DFSP. Clinically, it was a large plaque with atrophic areas and several protuberant nodular areas, typical of DFSP. Patient was referred for WLE.

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