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 1883 - 16 Aug - Dr Diwan

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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49 year-old female with history of right breast carcinoma, status post mastectomy, with biopsy of a lesion on the left chest wall. Immuno' to follow.


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vincenzo polizzi

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I think this is a typical example of Toker cells hyperplasia, with a scant atypical, Paget-like component (at the tip of rate ridge in fig6 and along the side edge in fig5). The important question is: are these cells Paget cells or atypical but yet Toker cells?

Useful a p53, CD138, estrogen/progesteron and HER2/Neu coloration.

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urmilapandey

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Morphology looks benign, would have done immunos to exclude Paget's but on morphology favour benign Toker cells

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Robledo F. Rocha

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I don't think the mere quantitative increase of Toker’s cell is strong enough to manifest itself as a lesion clinically noticeable. Maybe the critical point of this spot diagnosis really is distinguish between Toker’s cells hyperplasia and mammary Paget’s disease, in which case I favor the former hypothesis due to the lack of pleomorphism and nuclear atypia, but I presume the true lesion that have motivated the biopsy is a fibroadenoma of the residual breast in the deeper reaches of the specimen, suggested by elongated ducts with epithelial and myoepithelial bilayered lining embedded in an abundant loosely cellular fibromyxoid stroma.

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Raul Perret

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Also thought of Toker's cells hyperplasia associated with Fibroadenoma.

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Dr. Hafeez Diwan

Posted · Report

Supernumerary nipple with Toker cell hyperplasia (clinically, this was a supernumerary nipple).  The Toker cells were Cam5.2 and CK7 positive.  ER was also positive.  Her-2Neu was negative.

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Dr. Hafeez Diwan

Posted · Report

A minor correction about the immuno images above: CK7 is actually Cam 5.2 (but CK7 looks similar); and the other two immunos are both ER.  Sorry!

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