PMC4363975_01
A slightly indurated well-demarcated ulcer, slightly pearly in periphery
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F1
An 80-year-old man was referred with the well-demarcated, indurated plaque with central necrotic ulceration on his left upper eyelid [Fig. 1].
(a) Punch biopsy of upper eyelid lesion showed epidermal ulceration, with underlying pandermal and epidermotropic lymphocytic infiltrate, composed nearly entirely of large atypical lymphocytes, extending to and involving subcutis (H&E, x40). (b) Composed predominantly of a diffuse monotonous population of large, cytologically atypical mononuclear cells, exhibiting nuclear pleomorphism, with hyperchromatic to vesicular convoluted nuclei, some with prominent nucleoli, and moderate amount of cytoplasm, comprising approximately 80% of total cellularity (H&E, x100). (c) Immunohistochemically, large neoplastic lymphocytes showed predominantly cytotoxic phenotype with diffuse positivity for CD8, and essential negativity for CD4 (not shown)
IJO-63-81-g002.jpg
PMC4363975_01_IJO-63-81-g002.jpg
F2
A biopsy was performed and histology showed appearances suggestive of a malignant lymphoma [Fig. 2].