Du Xufeng, Yin Xingping, Zhou Nan, Zhang Guolong, Shi Hejian, Cao Shuanglin
Department of Dermatology, Wuxi People's Hospital, Wuxi 214023, China.
J Cutan Pathol. 2010 Jun;37(6):683-6. doi: 10.1111/j.1600-0560.2009.01336.x. Epub 2009 Jul 14.
Extramammary Paget's disease (EMPD) is an uncommon skin neoplasm characterized by Paget's cells with pale-staining cytoplasm in the epidermis, and cases with distinguished acantholysis but lacking characteristic Paget's cells were rarely reported in the literature.
An 80-year-old male with lesion on scrotum was screened histologically and immunohistologically for the diagnosis of his tumor.
Histological examination showed acanthosis with cellular atypia and focal acantholysis, consistent with acantholytic squamous cell carcinoma in situ (SCCIS). No characteristic Paget's cells were observed in low magnification. Immunohistochemical staining showed carcinoembryonic antigen (CEA), cytokeratin 7 (CK7) and cytokeratin 8 (CK8) to be strongly expressed in the nests and singly arranged large tumor cells, and the surrounding epidermis was positive for CK5/6 and negative for CEA. Sporadic periodic acid-schiff (PAS)-positive cells could be seen in some areas.
These findings strongly indicated the diagnosis of EMPD mimicking acantholytic SCCIS.
乳房外佩吉特病（EMPD）是一种罕见的皮肤肿瘤，其特征为表皮内具有淡染细胞质的佩吉特细胞，而文献中很少报道有明显棘层松解但缺乏特征性佩吉特细胞的病例。
对一名80岁阴囊有病变的男性进行组织学和免疫组织学检查以诊断其肿瘤。
组织学检查显示棘层肥厚伴细胞异型性和局灶性棘层松解，符合棘层松解性原位鳞状细胞癌（SCCIS）。低倍镜下未观察到特征性的佩吉特细胞。免疫组织化学染色显示癌胚抗原（CEA）、细胞角蛋白7（CK7）和细胞角蛋白8（CK8）在巢状及单个排列的大肿瘤细胞中强表达，周围表皮CK5/6阳性，CEA阴性。部分区域可见散在的过碘酸希夫（PAS）阳性细胞。
这些发现强烈提示诊断为模仿棘层松解性SCCIS的EMPD。
