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A and B: Bilateral auricular lesions. Left ear after the biopsy. C and D: Both ears after radiation therapy.
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Both ears displayed irregular, slightly tender soft tissue infiltrates (Fig. 1A/B). The patient received external beam radiation to both earlobes to a total dose of 3000 cGy in 15 fractions with complete resolution of the lesions (Fig. 1, C/D).
Left ear skin biopsy. A section demonstrates dense dermal infiltrate composed of mature appearing lymphocytes and abundant plasma cells, 40x (A) that show kappa light chain stain, 10x (B), lack of lambda light chain stain, 10x (C), and CD20 expression, 20x (D).
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On biopsy, the skin of the left superior ear lesion showed dense, dermal lymphoplasmacytic infiltrate (Fig. 2A) composed of abundant kappa restricted plasma cells (Fig. 2B/C) expressing CD138 and CD20 (Fig. 2D).