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Clinical Problem Solving: Pathology
November 2004

Pathology Quiz Case 1

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2004;130(11):1336. doi:10.1001/archotol.130.11.1336

A 38-year-old white woman presented with a 6-year old history of an increasing number of erythematous nodules around her left ear. The lesions had developed in the concha and expanded to the external acoustic meatus and the retroauricular area. The patient mainly complained about itching. There was no earache, otorrhea, or hearing loss. There were no signs of infection or other systemic symptoms. There was no history of collagen-vascular disease or malignancy of any kind.

Physical examination revealed multiple dry, partly confluent, bullous lesions measuring up to 0.5 cm in diameter and involving the concha, external acoustic meatus, and retroauricular area (Figure 1). There was no evidence of lymphadenopathy. Histologic examination of an excised nodule showed small vessels lined with endothelial cells with prominent nuclei in an inflammatory infiltrate consisting of lymphocytes, plasma cells, and eosinophilic granulocytes (Figure 2, Figure 3, and Figure 4).

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