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Clinical Challenge | Pathology

A Dark Pigmented Spot in the Nasopharynx QUIZ

Yi-Zhi Lin, MD1; Yun-Ho Lin, DDS, MS2; Shih-Han Hung, MD, MS1,3
[+] Author Affiliations
1Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan
2Division of Oral Pathology, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
3Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan
JAMA Otolaryngol Head Neck Surg. 2015;141(7):661-662. doi:10.1001/jamaoto.2015.0670.
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A man in his 60s with a history of hyperlipidemia, gout, and sleep apnea was seen an incidental finding of a left torus tubarius, blackish, mucosal lesion. He had no nasal obstruction, nasal bleeding, or feeling of aural fullness. Fibroscopic evaluation revealed a black nevus–like lesion over the left torus tubarius, without surface necrosis or signs of bleeding. Microscopy revealed small mixed serous and mucinous glands, normal respiratory epithelia with marked oncocytic cell changes, and abundant eosinophilic granular cytoplasm arranged in a tubular and microcystic pattern. What is the diagnosis?

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A, Endoscopic view of the nasopharynx. B-D, Histopathologic images. B, Hematoxylin-eosin, original magnification ×100. C, Hematoxylin-eosin, original magnification ×200. D, Iron stain, original magnification ×100.

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