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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 4475 - 15 March 2024 Posted By: Admin_Dermpath

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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20-year-old woman, single tumour of the nose non regressive after 6 months.
Contributor: Pr. Béatrice VERGIER


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vincenzo

Posted

Primary Cutaneous CD4+ Small/Medium T-cell Lymphoproliferative Disorder. In the last pic you can see small/medium sized cells surrounding immunoblasts with the characteristic rosette pattern. These cells should be CD4+/PD1+ and the immunoblasts should be B cells; and this is why I misinterpreted this tumor as a TCRBCL, some time ago. 

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vincenzo

Posted

...as long as I’m not making a mistake this time too. 

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Admin_Dermpath

Posted

Thank you for your comments. 

After a full immunochemical panel the final diagnosis is:  T-helper follicular (THF) lymphoproliferation

The differential diagnoses to consider are:

Pseudolymphoma
Insect bite reaction
Primary cutaneous CD4+ small/medium T-cell lymphoma
Cutaneous T-cell lymphoma, NOS

I have uploaded the immunochemistry of this case also.
 

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