阴囊Paget病7例临床病理分析  

Paget’s disease of the scrotum: a clinicopathological analysis of seven cases

作　　者：王磊[1] 周彩婷 马怡君 韩微 杨家佳[1] 王军 WANG Lei;ZHOU Cai-ting;MA Yi-jun;HAN Wei;YANG Jia-jia;WANG Jun(Department of Pathology,the Afiliated Hospital of Yangzhou University,Yangzhou 225009,China;Dalian Medical University,Dalian 116044,China;Department of Pathology,Yizheng People's Hospital,Yizheng 211400,China)

机构地区：[1]江苏省扬州大学附属医院病理科,江苏扬州225009 [2]大连医科大学,辽宁大连116044 [3]仪征市人民医院病理科,仪征211400

出　　处：《诊断病理学杂志》2022年第10期918-922,共5页Chinese Journal of Diagnostic Pathology

基　　金：江苏省扬州市科技局国际科技合作项目(YZ2020200)。

摘　　要：目的 总结分析阴囊Paget病的临床病理特征,提高对阴囊Paget病的诊断水平。方法 回顾性分析2012—2021年间在我院住院治疗的7例阴囊Paget病患者,总结与分析阴囊Paget病的临床表现、病理特征、诊断与鉴别诊断、临床治疗及预后。结果 阴囊Paget病好发于中老年人,疾病初期与湿疹相似,易发生误诊;镜下可在皮肤棘层、基底层内见散在或成簇分布的Paget细胞。免疫组化Paget细胞表达CK7、CEA、GCDFP-15及EMA。病灶范围较大时,皮肤切缘易残留而复发,若侵犯至真皮甚至发生淋巴结或远处转移,则预后较差。结论 阴囊Paget病是一种少见的低度恶性皮肤肿瘤,因进展缓慢易被漏诊。免疫组化检查对诊断与鉴别诊断具有重要意义。病灶范围较大时术后易复发,若侵犯至真皮甚至发生淋巴结或远处转移时预后较差,尽早活检后经病理确诊可明显改善患者预后。Objective To analyze the clinicopathological characteristics of Paget’s disease of the scrotum and to improve the diagnosis of Paget’s disease of the scrotum. Methods Seven patients with Paget’s disease of the scrotum were retrospectively analyzed in the Affiliated Hospital of Yangzhou University from 2012 to 2021. the clinical manifestations, pathological features, diagnosis and differential diagnosis, clinical treatment and prognosis were summarized and analyzed.Results Paget’s disease of the scrotum was more commonly found in middle-aged and elderly people. The initial stage of the disease was similar to eczema, and so it was easy to be misdiagnosed. Paget cells were scattered or distributed in clusters in the spinous layer and basal layer of the skin under microscope. By immunohistochemistry, Paget cells expressed CK7, CEA, GCDFP-15 and EMA. If the area of the lesion was large, the cut edge of the skin was easy to remain and recur. If it invaded the dermis or even had lymph node or distant metastasis, and therefore the prognosis was poor. Conclusion Paget’s disease of the scrotum is a rare low-grade skin tumor, which is easily missed due to its slow progress. Immunohistochemical examination is of great significance to diagnosis and differential diagnosis. If the lesion is large, it is easy to relapse after surgery. If it invades the dermis or even presents lymph node or distant metastasis, the prognosis is poor. Early biopsy and pathological diagnosis can significantly improve the patient’s prognosis.

关 键 词：阴囊PAGET病 临床病理 Paget细胞 免疫组化 鉴别诊断 

分 类 号：R737.2[医药卫生—肿瘤]