Interactive Case Study - January 2019

Question 1:

A 30-year-old man with a history of childhood leukemia presents with a sharply demarcated erythematous lesion on the back. The lesion has been present for five months. A biopsy is performed, showing the lesion below. Immunohistochemical staining reveals that the granular cells are negative for CD163 and S-100, but positive for CD68.
 
Click this image to view the virtual slide
 
 
Figure 1. A low-power, overall view (12x).

 
Figure 2. A low-power view (40x).

 
Figure 3. A medium-power view (100x).

 
Figure 4. A high-power view (200x).

 
Figure 5. A high-power view of the edge of the lesion (200x).

 
Figure 6. A higher-power view (400x).

 
Figure 7. CD163 stain of the tumor (200x).

 
Figure 8. S-100 stain of the tumor (200x).

 
Figure 9. CD68 stain of the tumor (200x).


 
What is the most likely diagnosis?

A.	Granular cell dermatofibroma

B.	Granular cell leiomyoma

C.	Granular perineurioma

D.	Granular cell tumor

E.	Primitive polypoid granular cell tumor