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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.
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Case Number : Case Number : Case 1910- 22 Sept - Dr Iskander Chaudhry Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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85 year old. Short history of nodular tumourous lesions appearing on lower legs. Left thigh incisional biopsy
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Edited by Admin_Dermpath

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urmilapandey

urmilapandey 15

Posted (edited)

agree and would also include a myeloma in the differential

Edited by urmilapandey

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Nitin Khirwadkar

Nitin Khirwadkar 63

Posted

Agree with the differentials above. Needs IHC.

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Sasi Attili

Sasi Attili 85

Posted

3 hours ago, Raul Perret said:

Lymphoma plasmablastic vs PCDLBL leg type

agree

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vincenzo polizzi

vincenzo polizzi 185

Posted

Yes it’s a plasmacytic/plasmablastic family’s member, but I think this should be an extramedullary manifestation of plasmablastic myeloma rather then a plasmablastic lymphoma... or an extramedullary plasmocytoma.  

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Admin_Dermpath

Admin_Dermpath 1,197

Posted

The tumour is negative for T and B cell markers .... Iskander Chaudhry 

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Raul Perret

Raul Perret 262

Posted (edited)

CD138, Ki67, EBER?

Edited by Raul Perret

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vincenzo polizzi

vincenzo polizzi 185

Posted

...in keeping with plasmocytoma/myeloma (BCL2? CD138? CD38? CD56?)

plasmablastic lymphoma usually shows similar immunophenotype, but I don’t find the typical macronucleolus of plasmablastic ly. But these are spot observations of course.  

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Admin_Dermpath

Admin_Dermpath 1,197

Posted

Hi All 

The lesional cells are:

Positive for: CD45, CD43, CD138, CD56 (patchy), Kappa light chain restriction (mRNA)

Negative for: CD3, CD5, CD20, Pax5. 

Ki67 - high proliferation 

Your final diagnosis is: ........

 

Iskander

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Raul Perret

Raul Perret 262

Posted

Link without CPC and EBER I would be extremely cautious before rendering a definitive diagnosis

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Agree

plasmablastic lymphoma vs. Plasmacytoma/myeloma

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

1 hour ago, Raul Perret said:

Link without CPC and EBER I would be extremely cautious before rendering a definitive diagnosis

Nice article, thanks Raul.

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Admin_Dermpath

Admin_Dermpath 1,197

Posted

Thanks everyone!

 

Great discussion!! 

 

So patient has history of myeloma; HIV negative, EBER negative

 

Our final diagnosis was: 

 

Plasmablastic plasma cell myeloma

 

 

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