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Clinical Problem Solving: Pathology
February 2004

Pathology Quiz Case 1

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2004;130(2):238. doi:10.1001/archotol.130.2.238

An 85-year-old man presented with a 2-month history of an intermittently bleeding lesion on his left auricle. A polypoid, fragile, red mass, measuring 3 cm in diameter and covered with hemorrhagic crusts, was observed on the helix-antihelix region of his left ear (Figure 1). There were no palpable cervical lymph nodes. Examination of the patient's ears, nose, and throat revealed no other abnormalities. The lesion was excised with a 1-cm safety margin of normal tissue. Histopathologic examination of the lesion revealed fascicles of spindle cells and single or multiple nucleated bizarre cells with redundant cytoplasm (Figure 2). Typical and atypical mitoses were observed. Immunohistochemical stains were negative for keratin, HMB-45, and S100 protein and positive for CD68 (Figure 3) and vimentin. After 1 year of follow-up, the patient was doing well, with no recurrence.

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