title: Epstein-Barr virus-positive Hodgkin lymphoma-like earlobe lymphoid infiltrate: case report.
abstract: Hodgkin lymphoma (HL) is a malignancy of the lymph system usually occurring on the lymph nodes. A 57-year-old Japanese woman presented with the chief complaint of an enlarging tumor of the left ear. An excisional biopsy was taken, and histological examination showed a mixed infiltration of cells, including Reed-Sternberg cells and their mononuclear forms against a background of small lymphocytes. Reed-Sternberg cells were CD15, CD20, CD30, Ki-67, MUM-1, CD45, EMA, and Epstein-Barr virus-encoded small RNA was detected by in situ hybridization. We diagnosed this tumor as a skin infiltration with a lymphocyte-rich classical HL pattern. Skin involvement of HL is most often a secondary phenomenon representing a rare late manifestation of disease dissemination; however, we could not detect any evidence of systemic lesion for 6 months after the initial presentation. A case of HL only involving the skin was reported by several past reports, which termed it primary cutaneous HL. But, it is still controversial whether HL initially occurs on the skin because a diagnostic gray zone exists between HL, some non-HL entities, and nonneoplastic lymphoid infiltrates. Clinical and histological features of this case suggest that the skin will become a primary site of HL.
authors.affiliation: Department of Dermatology, Keio University, Tokyo, Japan. tanese@2001.jukuin.keio.ac.jp
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanese
authors.forename: Rei
authors.initials: R
authors.lastname: Haratoh
authors.forename: Kozo
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Akiko
authors.initials: A
authors.lastname: Wakabayashi
authors.forename: Rie
authors.initials: R
authors.lastname: Irie
authors.forename: Syunichi
authors.initials: S
authors.lastname: Miyakawa
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols; D001761:Bleomycin; D003606:Dacarbazine; D004317:Doxorubicin; D004427:Ear Diseases / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000473:pathology*; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D006801:Humans; D016130:Immunophenotyping; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D014747:Vinblastine
chemical_list: D015703:Antigens, CD; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin