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Clinical Problem Solving: Pathology
March 2006

Pathology Quiz Case

Author Affiliations

Tripler Army Medical Center, Honolulu, Hawaii



Arch Otolaryngol Head Neck Surg. 2006;132(3):349. doi:10.1001/archotol.132.3.349

A 21-year-old man presented with a nontender, nodular, hairless, red-brown lesion on the helix of his right ear. The lesion had grown slowly over a few months. A shave biopsy was performed and the wound healed by secondary intention. The patient returned 1 year later with a recurrent pigmented lesion at the original site (Figure 1 [A]) and a new, separate lesion on the lobule (Figure 1 [B]). An excisional biopsy was performed on both lesions, and the specimens were sent for histopathologic analysis. Low-power light microscopy revealed symmetry and maturation of nevus cells (Figure 2). High-power light microscopy revealed plump epithelioid cells (Figure 3 [A]) with characteristic junctional cleavage (Figure 3 [B]) and Kamino bodies (Figure 3 [C]). The patient tolerated the procedure well and still had no sign of recurrence 1 year after surgery.