Case 85

Surgical Pathology Case
 

CLINICAL INFORMATION

  A 58-year-old Caucasian female has a history of dermatofibroma and astigmatism. She presented to the clinic for a itchy lump behind the right ear in June 2007, and an infection was suspected and she was treated with antibiotics. However, one months later the lesion progressed with development of swelling and pain. There was widened purple streaks behind and over the right ear. The lesion was soft and spongy, and an incision was performed and some yellow-pink fluid was drained with a negative bacterial culture. She presented to the clinic two months after the onset of the lesion with an incisional biopsy.

GROSS DESCRIPTION

 

A purple-blue swelling is seen in the right postauricular area that measures 8.0 5 3 cm. There are areas of superficial breakdown and drainage of some serosanguineous and purulent fluid with minimal bleeding and no foul smell. The extent of the swelling is from the superior to the inferior edge of the postauricular groove without involvement of the pinna grossly. Multiple enlarged, firm and movable lymph nodes are noted in the right mandibular region, right anterior neck triangle and the posterior triangle on the right side of the neck.

     
 
     
 
 

HE, 4

HE, 10

 
 

HE, 20

HE, 10

 
 

HE, 20

HE, 20

 
 

HE, 20

HE, 40

 
 

HE, 40

HE, 40

     
 

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Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan