J Pathol Transl Med.  2016 Sep;50(5):394-396. 10.4132/jptm.2016.03.11.

Nodular Fasciitis of External Auditory Canal

• Ahn J
• Kim S
• Park Y

• KMID: 2353603
• DOI: http://doi.org/10.4132/jptm.2016.03.11

Abstract

Nodular fasciitis is a pseudosarcomatous reactive process composed of fibroblasts and myofibroblasts, and it is most common in the upper extremities. Nodular fasciitis of the external auditory canal is rare. To the best of our knowledge, less than 20 cases have been reported to date. We present a case of nodular fasciitis arising in the cartilaginous part of the external auditory canal. A 19-year-old man complained of an auricular mass with pruritus. Computed tomography showed a 1.7 cm sized soft tissue mass in the right external auditory canal, and total excision was performed. Histologic examination revealed spindle or stellate cells proliferation in a fascicular and storiform pattern. Lymphoid cells and erythrocytes were intermixed with tumor cells. The stroma was myxoid to hyalinized with a few microcysts. The tumor cells were immunoreactive for smooth muscle actin, but not for desmin, caldesmon, CD34, S-100, anaplastic lymphoma kinase, and cytokeratin. The patient has been doing well during the 1 year follow-up period.

Keyword

Nodular fasciitis; External auditory canal; Ear

MeSH Terms

Actins
Calmodulin-Binding Proteins
Desmin
Ear
Ear Canal*
Erythrocytes
Fasciitis*
Fibroblasts
Follow-Up Studies
Humans
Hyalin
Keratins
Lymphocytes
Lymphoma
Muscle, Smooth
Myofibroblasts
Phosphotransferases
Pruritus
Upper Extremity
Young Adult
Actins
Calmodulin-Binding Proteins
Desmin
Keratins
Phosphotransferases

Figure

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  Fig. 1. Radiologic finding. An ovoid mass with soft tissue density (arrow) is noted in the right external auditory canal on computed tomography.

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  Fig. 2. Pathologic findings. (A) Spindle cell proliferation shows a vaguely storiform to fascicular pattern. (B) The bland spindle and stellate cells are set in loose myxoid (upper portion) to hyalinized matrix (lower portion). Extravasated red blood cells and scattered lymphoid cells are identified. (C) The tumor cells are positive for smooth muscle actin.

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