B-cell chronic lymphocytic leukemia with bilateral ear involvement.

Abstract

A 66-year-old woman presented with multiple, painless, plum-colored nodules in both ears for the past year, associated with partial destruction of the auricular cartilage [Figures 1a and b]. The histopathologic examination revealed a monomorphic lymphocyte infiltrate that expressed CD5, CD20, CD23, CD43 and was negative for CD3, CD10, cyclin D1, Bcl2, and Bcl6. The findings were compatible with B-cell chronic lymphocytic leukemia (CLL-B). The myelogram done showed a lymphocyte clone with a similar immunohistochemical profile. Pan-body CT-scan and blood tests were normal. This patient responded well to local radiation therapy (total dose of 16 Gy) with resolution of the nodules.