Samarasinghe D, Frost F, Sterrett G, Whitaker D, Ingram D, Sheiner H
Hospital and University Pathology Services (HUPS), Sir Charles Gairdner Hospital (SCGH), Nedlands, Western Australia.
Diagn Cytopathol. 1993;9(3):291-5. doi: 10.1002/dc.2840090309.
Five cases of mammary Paget's disease were diagnosed by nipple scrape cytology. The neoplastic material obtained was abundant in two cases, moderate in one, but in two, only a few cell aggregates feature in three cases and this, together with dense tumour cell cytoplasm and the background of keratinous debris, may impart a squamous-like appearance; however, three-dimensional cell aggregates, papillary-like groups, acinar-like collections, and some cells with vacuolated cytoplasm and eccentric nuclei allowed glandular differentiation to be inferred in three cases. In four cases a combination of clinical evaluation, and cytological findings of malignant cells compatible with Paget's disease was used so that mastectomy could proceed, and in one case there was frozen section confirmation of an underlying invasive carcinoma. In the single case in which it was performed, there was positive immunoperoxidase staining for c-erb B2 oncoprotein. Demonstration of this protein, CEA, or mucin, helps distinguish Paget's disease from melanoma or squamous cell carcinoma in-situ.
通过乳头刮片细胞学检查诊断出5例乳腺佩吉特病。在2例中获得的肿瘤物质丰富，1例中等，但在2例中，只有少数细胞聚集体，3例中有此特征，再加上肿瘤细胞质致密以及角质碎片背景，可能呈现出鳞状外观；然而，三维细胞聚集体、乳头状组、腺泡状集合以及一些具有空泡状细胞质和偏心核的细胞，使得3例中可以推断出腺管分化。在4例中，结合临床评估以及与佩吉特病相符的恶性细胞的细胞学发现，从而能够进行乳房切除术，在1例中，冰冻切片证实存在潜在浸润性癌。在进行该项检查的唯一1例中，c-erb B2癌蛋白免疫过氧化物酶染色呈阳性。该蛋白、癌胚抗原或黏液的显示有助于将佩吉特病与黑色素瘤或原位鳞状细胞癌区分开来。
