Liao Xiujun, Mao Weiming, Lin A'Li
Departments of Colorectal Surgery, The 3rd People's Hospital of Hangzhou, Hangzhou, China.
Departments of Pathology, The 3rd People's Hospital of Hangzhou, Hangzhou, China.
Case Rep Gastroenterol. 2014 May 15;8(2):186-92. doi: 10.1159/000363177. eCollection 2014 May.
Perianal Paget's disease (PPD) represents a skin neoplasm which can be either primary or secondary to carcinoma from an adjacent internal organ. PPD with underlying colorectal adenocarcinoma is usually looked upon as a secondary disease. We report a rare case of co-associated PPD and anorectal adenocarcinoma. The PPD was found to be located near the anorectal adenocarcinoma with normal tissues between them. Immunohistochemical stains demonstrated that the Paget's cells were CK7+/GCDFP-15-/CK20-/MUC2-/CDX2-, whereas the anorectal adenocarcinoma was shown to be CK7+/GCDFP-15-/CK20+/MUC2+/CDX2+. This immunological phenotypic profile supported the notion that PPD and anorectal adenocarcinoma were of different origins, but could not define the exact origins of PPD. In our determination, this case was a primary PPD with anorectal adenocarcinoma. PPD remains a heterogeneous and complex pathology, and additional studies are required to differentiate between the various possible origins.
肛周佩吉特病（PPD）是一种皮肤肿瘤，可为原发性，也可继发于相邻内部器官的癌。伴有潜在结直肠腺癌的PPD通常被视为继发性疾病。我们报告了一例罕见的PPD与肛管直肠癌并存的病例。发现PPD位于肛管直肠癌附近，两者之间为正常组织。免疫组化染色显示，派杰细胞CK7+/GCDFP-15-/CK20-/MUC2-/CDX2-，而肛管直肠癌为CK7+/GCDFP-15-/CK20+/MUC2+/CDX2+。这种免疫表型特征支持PPD和肛管直肠癌起源不同的观点，但无法确定PPD的确切起源。我们判定，该病例为原发性PPD合并肛管直肠癌。PPD仍然是一种异质性和复杂性的病理情况，需要更多研究来区分各种可能的起源。
