Ishizawa T, Mitsuhashi Y, Sugiki H, Hashimoto H, Kondo S
Department of Dermatology, Yamagata University School of Medicine, Yamagata, Japan.
Dermatology. 1998;197(4):388-90. doi: 10.1159/000018039.
An 85-year-old Japanese woman had noticed erythema on her vulvar region 3 years before. The erythema gradually increased in size and followed erosion and ulceration with pigmentation on the edge of the erythema. A skin biopsy from the pigmented area showed large round cells with ample cytoplasm, which formed nests or glandular structures. In the dermis there was mass formation of basophilic cells and peripheral cells in a palisade arrangement. The tumor cells in the epidermis showed positive immunoreactivity for carcinoembryonic antigen; on the other hand, the dermal tumor was negative. We diagnosed that the tumor in the epidermis was vulvar Paget's disease, and the dermal tumor was a solid type of basal cell carcinoma. We speculate that the vulvar Paget's disease preceded and then the basal cell carcinoma developed in the area of Paget's disease. This is the first report in which basal cell carcinoma in the area of Paget's disease was documented.
一名85岁的日本女性3年前注意到其外阴部出现红斑。红斑面积逐渐增大，随后出现糜烂和溃疡，红斑边缘有色素沉着。对色素沉着区域进行皮肤活检，结果显示有大量细胞质丰富的圆形大细胞，这些细胞形成巢状或腺状结构。真皮层有嗜碱性细胞团块形成，周边细胞呈栅栏状排列。表皮中的肿瘤细胞癌胚抗原免疫反应呈阳性；另一方面，真皮层肿瘤呈阴性。我们诊断表皮中的肿瘤为外阴佩吉特病，真皮层肿瘤为实体型基底细胞癌。我们推测外阴佩吉特病先出现，然后在佩吉特病区域发生了基底细胞癌。这是首次记录到佩吉特病区域出现基底细胞癌的报告。
