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A 35-year-old woman presented with a 2 cm left ear concha fluctuant swelling that had gradually increased in size over 2 months (figure 1). There were no lesions nor lymphadenopathy elsewhere. The initial clinical impression was an ear pseudocyst. The lesion was subsequently excised. Intraoperative findings were those of a cystic lesion with a thickened anterior wall. Fragments of the ‘cyst’ wall were sent for histological review. Review the high quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2020-206475.R2.ndpi/ and consider your diagnosis.
Five differential diagnoses
Lymphohistiocytic infiltrate, possibly infectious.
Rosai-Dorfman disease (RDD).
Soft tissue neoplasm.
The correct answer is after the discussion.
RDD, also …
Handling editor Iskander Chaudhry.
Contributors GZLT and TPT conceived of the presented idea. GZLT, FP, XX and TPT all contributed towards the the writing of the manuscript. TPT supervised the project.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.