A case of lymphoid proliferation of the ear
Cutaneous T-cell lymphomas usually have a CD4+, CD8− T-cell phenotype. A CD8+ T-cell phenotype may be rarely found in cases of mycosis fungoides, uncommon cases of primary cutaneous CD30+ lymphoproliferative disorder, around half of the cases of pagetoid reticulosis, and cases of subcutaneous panniculitis-like T-cell lymphoma with an alpha/beta T-cell phenotype, and in approximately, one-fifth of the cases of peripheral T-cell lymphoma (PTL), unspecified.

Published in the Indian Journal of Dermatology, the authors report a case of a CD8+ lymphoid proliferation presenting on the ear with characteristic clinical, morphologic, immunohistochemical features and may represent a new clinical condition.

A 38-year-old female patient came with complaints of a single nodular swelling over the left ear which was associated with mild itching. The patient gave a history of noticing a swelling over the left ear 3 years back. It was a small, single lesion that gradually grew in size over 3 months. The patient noticed improvement of lesion with reduction in size on treatment with topical medication and recurrence of lesions on stopping treatment.

There was no history of change in the size of lesion over the past 1 year. The patient had complained of pain associated with lesion for 4 months. The routine investigations were within normal limits. Clinical differential diagnosis included Jessner's lymphocytic infiltrate, lupus vulgaris, leishmaniasis, and discoid lupus erythematosus.

A skin biopsy for histopathological evaluation revealed the epidermis to be atrophied with mild hyperkeratosis and dermis showed dense infiltrate of medium-sized monomorphic lymphoid cells with round to irregular nuclear margin and blastoid chromatin. The infiltrate extended into the subcutaneous adipose tissue. In the fat tissue, no rimming of adipocytes was seen. Epidermotropism and angioinvasion were not evident.

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