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Virtual case of the month
An intriguing ‘cyst’ of the ear
  1. Gideon Ze Lin Tan1,
  2. Fredrik Petersson1,
  3. Xinni Xu2,
  4. Thomas P Thamboo1
  1. 1 Pathology, National University Hospital, Singapore
  2. 2 Department of Otolaryngology–Head and Neck Surgery, National University Hospital, Singapore
  1. Correspondence to Dr Gideon Ze Lin Tan, Pathology, National University Hospital, Singapore 119074, Singapore; Gideon_tan{at}nuhs.edu.sg

https://doi.org/10.1136/jclinpath-2020-206475

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    Clinical question

    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.

    Figure 1

    Clinical image of the ear swelling.

    Five differential diagnoses

    1. Lymphoproliferative disorder.

    2. Lymphohistiocytic infiltrate, possibly infectious.

    3. Metastatic melanoma.

    4. Rosai-Dorfman disease (RDD).

    5. Soft tissue neoplasm.

    The correct answer is after the discussion.

    Discussion

    RDD, also …

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    Footnotes

    • 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.