摘要
目的 探讨原发于外阴的伴间质浸润的乳腺外Paget病的病理组织学特征.方法 对美国亚利桑那大学医学中心2008～2013年5例行外阴手术且术后诊断为伴间质浸润的外阴Paget病进行回顾性分析,观察其临床病史、大体及镜下特征、免疫表型.结果 5例均表现为皮肤片状增厚、红斑状及灰白色病变,部分伴表面糜烂,皮纹消退,边界不规则;镜下见肿瘤细胞形态分布多样性,呈单个、小簇状、巢状、腺样及不规则分支状;在微小浸润灶中肿瘤细胞呈芽孢状及小簇状浸润间质,而在浸润深度＞1 mm的病灶中肿瘤细胞在间质内呈不规则分支状及巢状浸润;免疫表型：CK7、CEA均呈强阳性,CK20、CDX2、HMB-45、ER、PR均呈阴性.结论 伴间质浸润的外阴Paget病病理形态呈多样性,浸润方式以芽孢状、鹿角状及巢状分布,周围可出现间质反应;免疫组化标记可鉴别类似于Paget病的其他肿瘤.
Purpose To study the histopathologic features of primary vulvar extramammary Paget＇s disease （EMPD） with stromal invasion.Methods Five surgical specimens with primary invasive vulvar Paget＇s disease were obtained from the United States University of Arizona medical center in 2008 ～ 2013.The clinical history,the gross and microscopic features,immunohistochemistry staining were analysed retrospectively.Results Five cases were generally showed flaky skin thickening,erythematous and greyish white lesions,part with surface erosion,striae subsided,irregular borders.Microscopically,tumor cells showed morphological diversity and distribution,such as single,small clusters,nested,adenoid and irregular branched.In microinvasive lesions,tumor cells showed the spore shape and small clusters of invasion,and in the depth of invasion ＞ 1 mm lesions,the tumor cells were irregular branching and nested invasion.Immunohistochemical staining showed that CK7,CEA were strongly positive expression,whereas the expression of CK20,CDX2,HMB-45,ER,PR were negative.Conclusion In vulvar Paget＇s disease with stromal invasion,the pathological features showed morphological diversity and distribution,the pattern of invasion was spore shape,staghorn and nests distribution,the stromal reaction around the tumor cells can be seen.Immunohistochemical staining can well identify other tumors similar to Paget＇s disease.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2014年第3期256-260,共5页
Chinese Journal of Clinical and Experimental Pathology
