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11例外阴佩吉特病的临床病理研究

[A clinicopathological study of 11 patients with Paget's disease of the vulva].

作者信息

Kodama S, Obata N, Hando T, Goto A, Ikarashi T, Takeuchi S, Sasagawa S, Watanabe T, Takahashi T, Kato M

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1985 Jun;37(6):861-70.

PMID:2991396
Abstract

A clinicopathological analysis of 11 patients with Paget's disease of the vulva was reported. A close association of this disease with cancer was strongly suggested in the histological examination. Nine of 11 patients had wide primary lesion; 4 patients had coexisting undifferentiated carcinoma (one patient with in situ sweat gland carcinoma) and one patient had squamous cell carcinoma in other lesion of the vulva. Five patients had downward growth of the tumor from the epidermis proper. There were, thus, only two patients who had Paget's cells confined within the epidermis. Three patients died of generalized metastasis of carcinoma and two patients had vulvar recurrence. The results of staining for PAS, PAS diastase resistant reaction, alcian blue, mucicarmin and carcinoembryonic antigen (CEA) were all positive in specimens with similar stainings to coexisting undifferentiated carcinoma of the vulva and metastasized lesions. CEA staining was positive in cytoplasm of Paget's cells and basal cells widely in the epidermis. It could be considered that the Paget's cells of the vulva originated multifocally from primitive stratum germinativum, which gave rise to the surface epithelium as well as all of the dermal appendages.

摘要

报道了11例外阴佩吉特病患者的临床病理分析。组织学检查强烈提示该疾病与癌症密切相关。11例患者中有9例原发灶广泛;4例伴有未分化癌(1例原位汗腺癌),1例在外阴其他病灶处有鳞状细胞癌。5例肿瘤从表皮向下生长。因此,仅有2例患者的佩吉特细胞局限于表皮内。3例患者死于癌的全身转移,2例患者出现外阴复发。在与外阴并存的未分化癌和转移病灶染色相似的标本中,过碘酸雪夫染色(PAS)、抗淀粉酶PAS反应、阿尔辛蓝、黏液卡红和癌胚抗原(CEA)染色结果均为阳性。CEA染色在外阴佩吉特细胞的细胞质以及表皮广泛区域的基底细胞中呈阳性。可以认为外阴佩吉特细胞多灶起源于原始生发层,该生发层产生表面上皮以及所有皮肤附属器。

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