The initial suspicion was an atheroma. During surgery I noticed, that it is a solid structure, well vasculated (4 strongly bleeding arteries ended in the tumor).
Histology: dermal manifestation of a Non Hodgkin Lymphoma
Blood works: CLL
That was very surprising.
The immunohistochemistry did then show: The patient had a CML since 8 years. Now a transformation into a AML did occur and what we saw was a dermal manifestation of a acute myeloid leukemia.
Very fascinating case.