Ferrara Gerardo, Filosa Alessandra, Mariani Maria Paola, Fasanella Luigi
Anatomic Pathology Unit, Macerata General Hospital, Via Santa Lucia, 2, 62100, Macerata, Italy.
Otorhyniloaryngology Unit, Civitanova Marche General Hospital, Civitanova Marche, Italy.
Head Neck Pathol. 2018 Jun;12(2):252-254. doi: 10.1007/s12105-017-0842-x. Epub 2017 Aug 4.
A biopsy specimen from the nasal mucosa of a 37-year-old man disclosed a subepithelial accumulation of black granules mainly running parallel to the surface in the absence of any inflammatory infiltrate. Since the mucosal pigment was negative with Perls' stain and resisted to melanin bleach, an exogenous pigmentation was suspected. The biopsy specimen had been taken because of a diffuse steel-blue pigmentation of the nasal mucosa, incidentally discovered during routine clinical examination. A diagnosis of occupational argyria of the nasal mucosa was finally made since the patient was a silver cleaner. Argyria is a rare cause of nasopharyngeal mucosal pigmentation; it is not a precancerous condition, but it can be mistaken for a melanosis or a melanocytic tumor both clinically and histopathologically. Clinicopathological correlation is mandatory, since the final diagnosis is based on a history of chronic silver exposure.
一名37岁男性的鼻黏膜活检标本显示，上皮下有黑色颗粒聚集，主要与表面平行，且无任何炎性浸润。由于黏膜色素对普鲁士蓝染色呈阴性且能抵抗黑色素漂白，怀疑为外源性色素沉着。该活检标本是因在常规临床检查中偶然发现鼻黏膜弥漫性钢蓝色色素沉着而采集的。由于该患者为银器清洁工，最终诊断为鼻黏膜职业性银沉着病。银沉着病是鼻咽黏膜色素沉着的罕见原因；它不是癌前病变，但在临床和组织病理学上都可能被误诊为黑变病或黑素细胞瘤。临床病理相关性是必不可少的，因为最终诊断基于慢性银暴露史。
