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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 4114 - 27 Oct 2022 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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24F, excision left shin 0.8cm pink dome-shaped nodule.
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Go to records October 2022

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IgorSC

Spitz tumor. Probably bening, despite the mitosis. I would like to see alk, ros, egfr and ntrk studies. I would bet Alk fused Spitz tumor. Many fusiform melanocytes and clefts inside nests.

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vincenzo

Same impression. Thinking of a "fuseroma", probably ALK fusion SN. There are well oriented nests of spindled/epithelioid cells, with elongated fascicular pattern. 

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msofopoulos

msofopoulos 4

Posted

I am thinking of Spitz (NTRK or ALK fusion) Have you done BRAF to exclude melanoma?

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Saleem Taibjee

Saleem Taibjee 0

Posted

Yes, I too had the impression of a plexiform/fascicular Spitz. But just to show that morphology does not always allow accurate prediction of driver mutation/fusion, in this case ROS-1 IHC was positive, and ALK/NTRK were negative. See below.

BW, Saleem

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vincenzo

Very, very educative case. When Alk neg, thing to ROS, his first competitor. Thanks, Saleem. 

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