乳腺外浸润性Paget病累及双侧腹股沟淋巴结的临床病理观察  

Invasive extramammary Paget disease involving bilateral inguinal lymph node: a clinicopathological analysis

作　　者：袁传涛[1] 韩庶勇 李磊[1] 郭静[1] 张仁亚[1] 

机构地区：[1]济宁医学院附属医院病理科,山东济宁272029 [2]单县东大医院病理科,山东单县274300

出　　处：《诊断病理学杂志》2014年第1期51-53,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺外浸润性Paget病(EMPD)的临床病理学特征、诊断和鉴别诊断。方法对1例阴囊EMPD累及双侧腹股沟淋巴结的临床病理学特征及免疫表型进行观察并复习相关文献。结果患者男性,71岁。临床表现为阴囊肿物逐渐增大伴破溃。组织学形态示表皮内大的、胞质空泡化的肿瘤细胞,以单个或数个聚集在一起呈巢状分布,瘤细胞突破基底膜浸润至真皮浅层,并累及双侧腹股沟淋巴结。免疫组化:CK、CK7、EMA、HER-2、cyclinD1、GCDFP-15和CEA均(+),而MC、CR、vimentin、CK5/6、CK20、PSA和HMB45(-)。结论乳腺外浸润性Paget病可根据浸润深度作为临床分期的分界点,最佳治疗方法是外科手术切除,其临床意义有待于长期观察随访。Objective To investigate the clinicopathologic features, diagnosis, and differential diagnosis of the dermal invasion of extramammary Paget disease （EMPD）. Methods The clinical and pathological features with immunostaining were described in detail in 1 case of EMPD in the scrotum involving bilateral inguinal lymph node, and related literatures were reviewed. Results A 71-year-old male complained of a growing mass with ulceration in the scrotum. The histopathological feature was an intraepidermal proliferation of large epithelioid cell. The cytoplasm showed varying degrees of vacuolization. The cells were arranged both as single units and in small clusters, and invaded through the basement membrane into the superficial dermis, and involved bilateral inguinal lymph node. Immunohistochemically, the tumor cells were positive for CK, CKT, EMA, Her-2, cyclinD1, GCDFP-15 and CEA, but negative for MC, CR, vimentin, CK5/6, CK20, PSA and HMB-45. Conclusions These results suggest that invasive EMPD can be divided according to invasion depth,and this might represent the basis for a useful, EMPD-specific staging system. Surgery remains the standard of care and most reliable method to control the disease. The clinical significance of invasive EMPD is unknown, and further studies with follow-up are required.

关 键 词：乳腺外PAGET病 阴囊 真皮浸润 转移 

分 类 号：R733.1[医药卫生—肿瘤]