Department of Organ Pathology, Tottori University, Faculty of Medicine, Yonago, Japan.
J Eur Acad Dermatol Venereol. 2013 May;27(5):589-92. doi: 10.1111/j.1468-3083.2012.04489.x. Epub 2012 Feb 25.
Extramammary Paget's disease (EMPD) is a distinct form of malignant skin neoplasm. Invasive EMPD is relatively rare and its detailed histopathological features have not been investigated to date.
Surgical specimens were obtained from 51 patients with primary invasive EMPD. Clinical data including lymph node status were retrieved from the patients' medical records. Cases were divided into subgroups according to invasion depth: dermal invasion ≤ 1 mm (minimal invasion) and dermal invasion > 1 mm in depth. Histological patterns (nodular/glandular pattern or micronodular pattern), lymphatic/venous invasion, mitosis and lymph node status were compared between the two groups.
The invasive EMPDs included 26 cases (51.0%) with dermal invasion ≤ 1 mm (minimal invasion) and 25 cases (49.0%) with dermal invasion > 1 mm in depth. Lymph node metastasis was detected in 2/26 (7.7%) patients with minimally invasive EMPD. Nodular/glandular pattern (72.0%), lymphatic/venous invasion (52.0%), mitosis (88.0%) and nodal metastasis (88.0%) were all significantly more frequent in cases with dermal invasion > 1 mm, compared to EMPDs with dermal invasion ≤ 1 mm (minimal invasion) (P < 0.001).
These results suggest that invasive EMPD can be divided according to invasion depth, with a cut-off depth of 1 mm. This might represent the basis for a useful, EMPD-specific staging system.
乳房外 Paget 病（EMPD）是一种独特的恶性皮肤肿瘤。侵袭性 EMPD 相对少见，其详细的组织病理学特征尚未得到研究。
从 51 例原发性侵袭性 EMPD 患者中获得手术标本。从患者病历中检索临床资料，包括淋巴结状态。根据浸润深度将病例分为两组：真皮浸润≤1mm（微小浸润）和真皮浸润深度>1mm。比较两组的组织学模式（结节/腺体模式或微结节模式）、淋巴管/静脉浸润、有丝分裂和淋巴结状态。
侵袭性 EMPD 包括 26 例（51.0%）真皮浸润≤1mm（微小浸润）和 25 例（49.0%）真皮浸润深度>1mm。2/26（7.7%）微小浸润性 EMPD 患者检测到淋巴结转移。与真皮浸润≤1mm（微小浸润）的 EMPD 相比，真皮浸润深度>1mm 的病例中，结节/腺体模式（72.0%）、淋巴管/静脉浸润（52.0%）、有丝分裂（88.0%）和淋巴结转移（88.0%）更为常见（P<0.001）。
这些结果表明，侵袭性 EMPD 可以根据浸润深度进行分类，以 1mm 为界限。这可能是一种有用的 EMPD 特异性分期系统的基础。
