Re: Bump on top of ear

[Guest guest]

Hi Tim,

Yes, I have had a bump on top of one ear that I called my

" Spock-ear " . I also developed a very swollen lobe on that

ear that has waxed and waned with treatment. I have asked

several Docs and the best guess is that " CLL blocks oil

ducts " but wait a sec... We are told that the white count

that can mount into the hundreds of thousands on our CBC

labs causes no viscosity change of the blood as some have

claimed. Thicker or more viscous blood is a myth in CLL with

high white count. I believe that Prof. Terry Hamblin has

stated this. OK, so what is the mechanism that causes this

ear lobe swelling and " Spock-ear " phenomenon?

The oil gland involvement may have some validity for top of

ear bumps, as I decided to squeeze it to see what came out

and it appeared to be a fatty whitish substance. The lobe

involvement on the other hand was more sensitive to

engorgement with mounting higher white count and receding

after TX suggesting fluid. Only under PCI TX has my lobe

contracted to near normal size with one incidence of

" flare " . This happened at the time I experienced facial

angioedema (probable cause = ACEi), lasted only a few days

and is now just slightly off color (faintly purple) at the

bottom, possibly pooled blood, and slightly fatter than

normal. Watching this suggests fluid (lymph??) retention and

engorgement during rapid tumor growth with draining during

tumor reduction. The other ear was also affected but to much

less degree.

A trivial but curiously earredeemable phenomenon of CLL. If

it happens in the ear it may mean it could be happening

elsewhere but we don't notice or can't see it.

WWW

[Guest guest]

Perhaps, it is just possible, that when one has a disease

like CLL or other chronic ills, the desire to attribute all

manner of things to it is something that goes along with

territory. One becomes hyper attuned to everything that

goes on in the body, and things like small bumps caused by a

blocked oil duct, normally either not noticed at all or

barely noticed loom large. Didn't notice it before so maybe

its the CLL.

I have these blocked oil ducts in a couple of places, the

ears and chest and have had them for a long time and I may

or may not even have CLL. It could just be a dx in the mind

of the pathologist and oncologist.

Anyway, unless they get inflamed, huge or just hurt, I'd

ignore them or go see a dermatologist if you're concerned.

[Guest guest]

Thanks, Wayne and for your responses.

Wayne, was unable to get anything out of the bump; the skin

was firm and healthy - not like a pimple, nor associated

with any channel to the surface. (Have had sebaceous

concentrations as you described, but this does not appear to

be one.) I agree, it suggests concentration of lymph, and

possibly infiltration with B-lymphocytes.

My dermatologist does not know what it is, either. She

wants to excise and biopsy the underlying tissue and I've

agreed. She thought it could be or possibly transform to

BCC. Both of us are super-prudent about anything cutaneous

after my multiple and ongoing SCC's.

Perhaps just another unexplained, earie effect of CLL.

Regards,

Tim

[Guest guest]

I've had lots of bumps & lumps in my scalp for the last 4

years. When I saw the Derma. he did a biopsy and the report

came back that CLL cells had infiltrated the layers of skin

(very rare). When my former Onc. saw the report he wanted

to start treatment yesterday. I then got 2 second options

from 2 CLL specialists who said NOT YET. I now see a CLL

specialist in Phila. If you have any other questions feel

free to contact on or off list.

Phil phs

[Guest guest]

Hi Phil,

Thanks for your response. Have heard of a few other cases

of cutaneous B-CLL infiltrates, too. One report was a study

cautioning Mohs surgeons that lymphocyte infiltrates can

complicate the task of obtaining clear margins in SCC and

BCC excisions.

I agree on the biopsy; my dermatologist is up on CLL & skin

cancer (I provided several papers to her) and she is super-

prudent in evaluating anything unusual. We will do that next

week.

Glad to hear you are seeing CLL specialists -- there is so

much CLL variability from patient to patient that a doctor

who has seen lots of CLL and works with it is the best

source of experienced judgement. Also, CLL specialists are

more likely to have clear, broadly evidence-based reasons to

delay or start treatment, rather than the pull-the-trigger-

just-to-be-safe reaction of a community hem/onc.

Thank you again for your perspective.

Regards,

Tim Klug