Lloyd J, Flanagan A M
Department of Histopathology, Northwick Park and St Mark's NHS Trust, Harrow, Middlesex, UK.
J Clin Pathol. 2000 Oct;53(10):742-9. doi: 10.1136/jcp.53.10.742.
Mammary and extramammary Paget's disease are uncommon intraepithelial adenocarcinomas. Both conditions have similar clinical features, which mimic inflammatory and infective diseases. Histological diagnostic confusion can arise between Paget's disease and other neoplastic conditions affecting the skin, with the most common differential diagnoses being malignant melanoma and atypical squamous disease. The glandular differentiation of both mammary Paget's disease and extramammary Paget's disease is indicated by morphological appearances, the presence of intracellular mucin in many cases, and positive immunohistochemical staining for glandular cytokeratins, epithelial membrane antigen, and carcinoembryonic antigen. This article provides an overview of mammary and extramammary Paget's disease and discusses recent evidence regarding the cell of origin. The concepts of primary and secondary Paget's disease are presented and the differential diagnosis is discussed with reference to immunohistochemical markers that might be of diagnostic value.
乳腺及乳腺外佩吉特病是罕见的上皮内腺癌。这两种情况具有相似的临床特征，类似炎症性和感染性疾病。佩吉特病与其他影响皮肤的肿瘤性疾病之间可能会出现组织学诊断混淆，最常见的鉴别诊断是恶性黑色素瘤和非典型鳞状疾病。乳腺佩吉特病和乳腺外佩吉特病的腺性分化通过形态学表现、许多病例中细胞内黏液的存在以及腺性细胞角蛋白、上皮膜抗原和癌胚抗原的免疫组化染色阳性来表明。本文概述了乳腺及乳腺外佩吉特病，并讨论了有关起源细胞的最新证据。介绍了原发性和继发性佩吉特病的概念，并参考可能具有诊断价值的免疫组化标志物讨论了鉴别诊断。
