Case History:

47 year old female smoker presented with an ulcerated mass on the dorsum of her tongue with bilateral cervical lymphadenopathy. Imaging demonstrated a 2 cm aggressive appearing lesion crossing the midline and involving the extrinsic tongue musculature. Subsequently developed blurred vision and altered sensation to left side of face.

Immunohistochemistry was negative for CD1a, Langerin, AE1/AE3, Alk and HMB45. S100 highlights background dendritic cells only. ERG and CD31 highlight the vascular pattern, CD3 and CD20 show a mixed lymphocytic population and there is no light chain restriction.