Skip to main content

Advertisement

SpringerLink
Log in

Melanotic oncocytic metaplasia of the nasopharynx: a report of seven cases and review of the literature

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

We describe seven cases of melanotic oncocytic metaplasia of the nasopharynx and review five other cases in the literature. It is usually a small, brown to black lesion that occurs around the Eustachian tube opening, where abundant seromucinous glands and lymphoid tissue are present. Multiple or bilateral lesions are sometimes seen. All 12 reported cases are of Asian origin. Melanotic oncocytic metaplasia occurs predominantly in men (male:female=11:1), with a mean age of 68 years. Simple excisional biopsy appears to be curative. Microscopically, melanotic oncocytic metaplasia is a combination of oncocytic metaplasia of the epithelium of the gland and melanin pigmentation in its cytoplasm. Fontana-Masson staining and immunohistochemical staining of S-100 protein revealed numerous melanocytes with conspicuous dendrites in the glands and stroma, which probably transfer melanin to adjacent glands. The exact pathogenesis of melanotic oncocytic metaplasia is unknown, but we postulate that the lesion could be related to the oncocytic metaplasia of the seromucinous glands around the Eustachian tube, which is followed by the local production and/or acquisition of the melanin pigment, under the influence of certain neuropeptides in the vicinity. The recognition of melanotic oncocytic metaplasia is of clinical importance, as it may be misdiagnosed as a malignancy to the unwary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ackermann AB, Chongchitnant N, Sanchez J, Guo Y, Bennin B, Reichel M, Randall MB (1997) Embryonic, histologic, and anatomic aspect. In: Stamathis G (ed) Histologic diagnosis of inflammatory skin disease. Williams & Wilkins, Baltimore, pp 18–21

  2. Barka T (1980) Biologically active polypeptides in submandibular glands. J Histochem Cytochem 28:836–859

    CAS  PubMed  Google Scholar 

  3. Benke TT, Zitsch RP 3rd, Nashelsky MB (1995) Bilateral oncocytic cysts of thenasopharynx. Otolaryngol Head Neck Surg 112:321–324

    CAS  PubMed  Google Scholar 

  4. Bing J, Poulsen K, Hackenthal E, Rix E, Taugner R (1980) Renin in the submaxillary gland: a review. J Histochem Cytochem 28:874–880

    CAS  PubMed  Google Scholar 

  5. Bracci-Laudiero L, Aloe L, Stenfors C, Tirassa P, Theodorsson E, Lundberg T (1996) Nerve growth factor stimulates production of neuropeptide Y in human lymphocytes. Neuroreport 7:485–488

    CAS  PubMed  Google Scholar 

  6. Gallagher JC, Puzon BQ (1969) Oncocytic lesions of the larynx. Ann Otol Rhinol Laryngol 78:307–318

    CAS  PubMed  Google Scholar 

  7. Goldman JL, Lawson W, Zak FG, Roffman JD (1972) The presence of melanocytesin the human larynx. Laryngoscope 82:824–835

    CAS  PubMed  Google Scholar 

  8. Hamperl H (1962) Oncocyten und Oncocytome. Virchows Arch 335:452–483

    CAS  Google Scholar 

  9. Hedin CA, Axell T (1991) Oral melanin pigmentation in 467 Thai and Malaysian people with special emphasis on smoker’s melanosis. J Oral Pathol Med 20:8–12

    CAS  PubMed  Google Scholar 

  10. Hirakawa E, Miki H, Ohmori M, Kobayashi S, Haba R, Nagai Y (1999) Melanin pigmented oncocytic metaplasia of the nasopharynx. Virchows Arch 434:455–457

    Article  CAS  PubMed  Google Scholar 

  11. Kurihara K, Nakagawa K (1997) Pigmented variant of benign oncocytic lesion of the pharynx. Pathol Int 47:315–317

    CAS  PubMed  Google Scholar 

  12. Lundgren J, Olofsson J, Hellquist H (1982) Oncocytic lesions of the larynx. Acta Otolaryngol 94:335–344

    CAS  PubMed  Google Scholar 

  13. Martinez-Madrigal F, Bosq J, Casiraghi O (1997) Major salivary gland. In: Sternberg SS (ed) Histology for pathologists. Lippincott-Raven, Philadelphia, pp 17–420

  14. Mathison R, Davison JS, Befus AD (1994) Neuroendocrine regulation of inflammation and tissue repair by submandibular gland factors. Immunol Today 15:527–532

    Article  CAS  PubMed  Google Scholar 

  15. Mills SE, Fechner RE (1997) Larynx and pharynx. In: Sternberg SS (ed) Histology for pathologists. Lippincott-Raven, Philadelphia, pp 391–403

  16. Morin GV, Shank EC, Burgess LP, Heffner DK (1991) Oncocytic metaplasia of the pharynx. Otolaryngol Head Neck Surg 105:86–91

    CAS  PubMed  Google Scholar 

  17. Murphy RA, Watson AY, Metz J, Forssmann WG (1980) The mouse submandibular gland: an exocrine organ for growth factors. J Histochem Cytochem 28:890–902

    CAS  PubMed  Google Scholar 

  18. Pikula DL, Harris EF, Desiderio DM, Fridland GH, Lovelace JL (1992) Methionine enkephalin-like, substance P-like, and beta-endorphin-like immunoreactivity in human parotid saliva. Arch Oral Biol 37:705–709

    CAS  PubMed  Google Scholar 

  19. Salata RA, Verbalis JG, Robinson AG (1987) Cold water stimulation of oropharyngeal receptors in man inhibits release of vasopressin. J Clin Endocrinol Metab 65:561–567

    CAS  PubMed  Google Scholar 

  20. Salo A, Ylikoski J, Uusitalo H (1993) Distribution of calcitonin gene-related peptide immunoreactive nerve fibers in the human submandibular gland. Neurosci Lett 150:137–140

    Article  CAS  PubMed  Google Scholar 

  21. Salonen L, Axell T, Hellden L (1990) Occurrence of oral mucosal lesions, the influence of tobacco habits and an estimate of treatment time in an adult Swedish population. J Oral Pathol Med 19:170–176

    CAS  PubMed  Google Scholar 

  22. Shek TW, Luk IS, Nicholls JM, Fok KO (1995) Melanotic oncocytic metaplasia of the nasopharynx. Histopathology 26:273–275

    CAS  PubMed  Google Scholar 

  23. Tang SC, Fend F, Muller L, Braunsteiner H, Wiedermann CJ (1993) High-affinity substance P binding sites of neurokinin-1 receptor type autoradiographically associated with vascular sinuses and high endothelial venules of human lymphoid tissues. Lab Invest 69:86–93

    CAS  PubMed  Google Scholar 

  24. Uddman R, Ekberg O, Malmberg L, Borgstrom P, Fernstrom G, Ekstrom J, Sundler (1990) Neuropeptide-containing nerve fibers in the pharynx of the rabbit. Dysphagia 4:220–226

    CAS  PubMed  Google Scholar 

  25. Uehara T, Matsubara O, Kasuga T (1987) Melanocytes in the nasal cavity and paranasal sinus. Incidence and distribution in Japan. Acta Pathol Jpn 37:1105–1114

    CAS  PubMed  Google Scholar 

  26. Ueyama T, Kozuki K, Houtani T, Ikeda M, Kitajiri M, Yamashita T, Kumazawa T, Nagatsu I, Sugimoto T (1990) Immunolocalization of tyrosine hydroxylase and vasoactive intestinal polypeptide in nerve fibers innervating human palatine tonsil and paratonsillar glands. Neurosci Lett 116:70–74

    Article  CAS  PubMed  Google Scholar 

  27. Unsal E, Paksoy C, Soykan E, Elhan AH, Sahin M (2001) Oral melanin pigmentation related to smoking in a Turkish population. Community Dent Oral Epidemiol 29:272–277

    Article  CAS  PubMed  Google Scholar 

  28. Weihe E, Krekel J (1991) The neuroimmune connection in human tonsils. Brain Behav Immun 5:41–54

    CAS  PubMed  Google Scholar 

  29. Whitley BD, Ferguson JW, Harris AJ, Kardos TB (1992) Immunohistochemical localisation of substance P in human parotid gland. Int J Oral Maxillofac Surg 21:54–58

    CAS  PubMed  Google Scholar 

  30. Xue WC, Hui YZ (1999) Melanotic oncocytic metaplasia of the nasopharynx. Histopathology 35:481–482

    Article  CAS  PubMed  Google Scholar 

  31. Yoshida Y, Tanaka Y, Hirano M, Nakashima T (2000) Sensory innervation of the pharynx and larynx. Am J Med 108[Suppl 4a]:51S–61S

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, University of Tokushima School of Medicine, 3-18-15 Kuramoto-cho, 770-8503, Tokushima, Japan

    Mika Sakaki, Mitsuyoshi Hirokawa & Toshiaki Sano

  2. Department of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong

    Tony W. H. Shek

  3. Department of Pathology, Oita Medical University, Oita, Japan

    Kenji Kashima, Tsutomu Daa & Ayako Gamachi

Authors
  1. Mika Sakaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tony W. H. Shek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mitsuyoshi Hirokawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenji Kashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tsutomu Daa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ayako Gamachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toshiaki Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mika Sakaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sakaki, M., Shek, T.W.H., Hirokawa, M. et al. Melanotic oncocytic metaplasia of the nasopharynx: a report of seven cases and review of the literature. Virchows Arch 444, 345–349 (2004). https://doi.org/10.1007/s00428-003-0970-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-003-0970-4

Keywords

Search

Navigation