Kobayashi T K, Ueda M, Nishino T, Kibe S, Higashida T, Watanabe S
Department of Cytopathology, Saiseikai Shiga Hospital, Imperial Gift Foundation, Inc., Japan.
Diagn Cytopathol. 1997 Feb;16(2):156-9. doi: 10.1002/(sici)1097-0339(199702)16:2<156::aid-dc13>3.0.co;2-l.
A case of histologically and immunocytochemically confirmed pemphigus vulgaris of the nipple examined by scrape cytology is reported. The scrape cytology showed isolated and somewhat loosely clustered cells with basophilic cytoplasm and vesicular hyperchromatic nuclei dysplaying prominent nucleoli, suggesting Paget's disease of the nipple. However, histological examination of the resected tissue together with the direct immunofluorescence technique for demonstration of in vivo-bound immunoglobulin to epithelium confirmed the diagnosis of pemphigus vulgaris. The use of an immunoperoxidase stain for IgG on the Papaniolaou-destained smear also gave a positive reaction on the cell membranes and provided a precise cellular diagnosis of the lesions. Cytodiagnostic pitfalls of these rare breast lesions are discussed, as well as the diagnostic value of immunocytochemistry.
报告了1例经刮片细胞学检查、组织学和免疫细胞化学确诊的乳头寻常型天疱疮病例。刮片细胞学显示细胞孤立且有些松散聚集，细胞质嗜碱性，核呈泡状深染，可见明显核仁，提示乳头佩吉特病。然而，切除组织的组织学检查以及用于显示体内结合于上皮的免疫球蛋白的直接免疫荧光技术证实为寻常型天疱疮。在帕帕尼科拉乌染色涂片上使用IgG免疫过氧化物酶染色，细胞膜上也呈阳性反应，对病变提供了精确的细胞诊断。讨论了这些罕见乳腺病变的细胞诊断陷阱以及免疫细胞化学的诊断价值。
