Lymphoma Pathology

Background: Non-Hodgkin's lymphoma (NHL) is associated with increased risk of cutaneous squamous cell carcinoma (cSCC), which tend to be more aggressive 1 .Whilst this relationship has been wellestablished, few cases demonstrate synchronous relapse of previously indolent NHL in the treatment course of cSCC which this case aims to highlight.Case report: A 68-year-old gentleman with a history of indolent non-Hodgkin's lymphoma presented with an ulcerated 3 9 3 9 4 cm left post-auricular lesion.The patient underwent left pinnectomy, parotidectomy and neck dissection which demonstrated a moderate-to-poorly differentiated cSCC of the left pinna with perineural, lymphovascular and intraparotid lymph node involvement.Histology also showed extra-nodal diffuse proliferation of atypical smallintermediate lymphoid cells adjacent to the squamous cell carcinoma favouring concurrent recurrence of atypical chronic lymphocytic leukaemia/ small-cell leukaemia.Discussion: Patients with a history of NHL are 5.5 times more likely to develop cSCC than those without NHL and also exhibit increased rates of local recurrence, metastases and mortality 2 .This case adds to the small number of documented reports of NHL recurrence identified in the treatment of aggressive cSCC 3 .It is crucial to be wary of abnormal dense lymphocytic infiltrates suggestive of recurrence or transformation in those with aggressive sCCs to prompt early intervention in progressive disease.