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An intriguing ‘cyst’ of the ear
  1. Gideon Ze Lin Tan1,
  2. Fredrik Petersson1,
  3. Xinni Xu2,
  4. Thomas P Thamboo1
  1. 1Pathology, National University Hospital, Singapore
  2. 2Department 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

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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.

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