左乳腺癌根治术后以乳房Paget病局部复发1例  

Paget's Disease as A Local Recurrence After Radical Mastectomy: A Case Report

作　　者：刘冬冬[1] 张江安[1] 于建斌[1] 徐武生[1] 李税琪[1] 曹瑞祥[1] 

机构地区：[1]郑州大学第一附属医院皮肤科,河南郑州450052

出　　处：《中国皮肤性病学杂志》2014年第7期731-732,769,共3页The Chinese Journal of Dermatovenereology

摘　　要：患者女,58岁。左胸壁局限性片状红斑、糜烂渗出3年。10年前行左乳腺癌根治术,术后病理诊断乳腺导管内癌。系统检查无异常,PET-CT未见全身转移征象。皮肤科检查见左胸壁12 cm×14 cm类圆形片状红斑,境界清楚,表面糜烂、渗出,底部潮红。皮损组织病理示:表皮内散在Paget细胞,圆形或卵圆形,胞质丰富,淡染成空泡状,核大深染,核周有空晕,真皮浅层单一核细胞浸润。特殊染色及免疫组化染色示:PAS(+),CK7(+),CK20(-),C-erbB-2(3+),EMA(+),CEA(-),GCDFP-15(-),ER(-),PR(-),S-100(-),LCA(-),Ki-67约60%(+)。诊断:1.左乳腺癌术后;2.胸壁乳房Paget病。转乳腺外科治疗及随访中。A 58-year-old female presented with 3 years history of a reddish patch with erosion and exudation on the left side of chest. The patient had a radical mastectomy of the left breast 10 years ago due to breast ductal carcinoma in situ. There were no complaints on systemic examination and PET-CT. Physical examination revealed a 12 cm × 14 cm reddish patch with erosion and exudation on the left side of thorzcic skin. Histopathological section showed Paget cells scattered within the lower part of epidermis. Specific stain and immunohistochemistry revealed PAS（ ＋ ）, CK7（ ＋ ）, CK20（ - ）, C-erbB-2（3 ＋ ）, EMA（ ＋ ）, CEA（ - ）, GCDFP-15（ - ）, ER （ - ）, PR（ - ）, S-100（ - ）, LCA（ - ） and about 60% cells were positive for Ki-67. A diagnosis of Mammary Paget＇s disease of the thoracic skin after mastectomy was made.

关 键 词：乳腺癌 复发 PAGET病 

分 类 号：R739.5[医药卫生—肿瘤]