We describe the first case of LPL simultaneously involving both auricles. Affected ears were the first manifestation of the disease that led to the diagnosis. The lack of appreciable systemic disease allowed sparing the patient from immunochemotherapy. Radiation therapy was used as a single modality and secured a stable remission. A putative pathogenesis of the paired auricular lymphoma is discussed and a literature review presented. While the role of genetic predisposition in our patient was uncertain, we postulate that symmetric ear lymphoma could have been caused by a combined effect of the homing of malignant lymphocytes whose localized growth was triggered by the hazardous environmental exposure.