[1][2] Patients usually present with otorrhea, conductive hearing loss, and otalgia, while bleeding and a sensation of a mass are much less common.

By gross description, there is usually a solitary, polypoid, reddish mass behind an intact ear drum (tympanic membrane).

[3] By microscopic exam, the polypoid appearance is maintained, showing a granulation-type tissue reaction with edematous stroma and a rich investment by capillaries.

[3][4][5] Immunohistochemistry is unnecessary for the diagnosis, but will highlight a mixed B- and T-cell population within the lymphoid component, without light chain (kappa or lambda) restriction.

The lesion presents in young patients, so the differential for a "polyp", especially when the lymphoid component is crushed or dominant, would include a rhabdomyosarcoma, extramedullary plasmacytoma, and a neuroendocrine adenoma of the middle ear.