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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 3004 - 11 January 2022 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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35 year old female with nodule on back.


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Richard Logan

Posted

I am concerned that this might be a manifestation of a malignancy, perhaps haematological.  Not sure of the significance of the ERG stain - this doesn't look like a vascular tumour.  More relevant clinical details and IHC please.

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IgorSC

Posted

I believe this is a vascular tumor that forms slit-like spaces and irregular vascular branches that dissects the colagen fibers. My first opinion this is a Kaposi sarcoma. I would do a HHV-8 stain.

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vincenzo

Posted

Watching at low magnification my first spot was of a retiform hemangioendothelioma. But RHE usually shows hobnail cells. A weird RH which doesn’t read the books...or am’I already getting “weird”?  ( :-)

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Meenakshi Batrani

Posted (edited)

There are vessels with inconspicuous lumen and endothelial cells having plump pale banal looking nuclei, and dense lymphoid infiltrate.  Thought of epithelioid haemangioma but don't see any eosinophil. Epithelioid Kaposi sarcoma is a possibility, need HHV-8 stain. 

Edited by Meenakshi Batrani

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Uma Sundram

Posted

This was a difficult case but the final consensus was that of a hemangioendothelioma. Both retiform and composite hemangioendotheliomas were considered. HHV 8 is negative. Long standing lesion on the back, slowly growing over time. No other history and the patient is young.

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