Quiz. WHAT IS YOUR DIAGNOSIS?

A 63-year-old male presented to our hospital with epistaxis. He is a heavy smoker with 40 cigarettes per day for 40 years. He had past history of hypertension under medical treatment. Several black nodules up to several millimeters were discovered at the nasopharynx during nasoscopic examination (Fig. 1). Microscopically, there were multiple small nodules composed of clusters of seromucinous glands under the overlying respiratory epithelium (Fig. 2A). The double-layered epithelium of these seromucinous glands showed diffuse oncocytic metaplasia with finely granular brown pigments in their cytoplasm (Fig. 2B). The brown pigments were stained positively for Fontana-Masson stain (Fig. 2C) and negative for Prussian blue stain. By immunohistochemistry, there were dendritic cells immunoreactive to S-100 protein and Melan-A (Fig. 2D), but not HMB-45.
Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan
2Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
3Department of Otolaryngology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
This work was partially supported by grants from E-DA Hospital (Grant number EDAHP103051).
Answers should be sent to the Editorial Office by 15.06.2014. The correct answer will be announced in the next issue of the Polish Journal of Pathology. All participants with the highest number of correct answers to the quizzes published in vol. 65 (4 issues) will be entered into the prize draw for a book.