Thread by @BinXu16

Time for another #grossognosis #ENTpath #Pedipath

Tongue lesion in a young kid.

@TheKarenPinto @renemaf @AnnieMcLeanDMD @DrAhmedKalebi @DrRolaAli @merva_st @TheKarenPinto @VijayPatho @doc_kartik @luishcruzc @kis_lorand

H&E: Sorry @DrAhmedKalebi No pseudoepitheliomatous hyperplasia. @OkelloAliker

Any differential? Any IHC/molecular you would like to have?

I should also mention that the patient is immune compromised.

This turns out to be EBV-associated smooth muscle tumor (HE/SMA/EBER). Kudo to @lizawati38

3 spindle cell tumors in immune compromised:
- KS
- EBV-SMT
- microbacterial spindle cell pseudotumor

Without clinical history: ddx broader including all cellular spindle cell lesions.