Difference between revisions of "Paget disease of the breast"

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'''Paget disease of the breast''', also '''[[Paget's disease]] of the breast''', is a thingy seen in the [[breast]]... and elsewhere - except bone.  It is abbreviated '''PDB'''.<ref name=pmid19919588>{{Cite journal  | last1 = Ellis | first1 = PE. | last2 = Maclean | first2 = AB. | last3 = Crow | first3 = JC. | last4 = Wong Te Fong | first4 = LF. | last5 = Rolfe | first5 = KJ. | last6 = Perrett | first6 = CW. | title = Expression of cyclin D1 and retinoblastoma protein in Paget's disease of the vulva and breast: an immunohistochemical study of 108 cases. | journal = Histopathology | volume = 55 | issue = 6 | pages = 709-15 | month = Dec | year = 2009 | doi = 10.1111/j.1365-2559.2009.03434.x | PMID = 19919588 }}</ref>
'''Paget disease of the breast''', also '''[[Paget's disease]] of the breast''' and '''Paget disease of the nipple''', is a thingy seen in the [[breast]].  It is abbreviated '''PDB'''.<ref name=pmid19919588>{{Cite journal  | last1 = Ellis | first1 = PE. | last2 = Maclean | first2 = AB. | last3 = Crow | first3 = JC. | last4 = Wong Te Fong | first4 = LF. | last5 = Rolfe | first5 = KJ. | last6 = Perrett | first6 = CW. | title = Expression of cyclin D1 and retinoblastoma protein in Paget's disease of the vulva and breast: an immunohistochemical study of 108 cases. | journal = Histopathology | volume = 55 | issue = 6 | pages = 709-15 | month = Dec | year = 2009 | doi = 10.1111/j.1365-2559.2009.03434.x | PMID = 19919588 }}</ref>


There is also a ''[[Paget disease of the bone]]'' - just to make things confusing.  This is dealt with in the ''[[bone]]'' article and has nothing (from a pathologic perspective) to do with the Paget disease discussed in this article; these two things just happened to be discovered by the same guy.
There is also a ''[[Paget disease of the bone]]'' - just to make things confusing.  This is dealt with in the ''[[bone]]'' article and has nothing (from a pathologic perspective) to do with the Paget disease discussed in this article; these two things just happened to be discovered by the same guy.


Non-bone Paget disease is subdivided into:
Non-bone Paget disease is subdivided into:
#Mammary Paget disease.
#Mammary Paget disease - dealt with in this article.
#Extramammary Paget disease.
#[[Extramammary Paget disease]].


Histologically, i.e. under the [[microscope]], the above are essentially identically; however, the associations (and prognosis) are quite different!
Histologically, i.e. under the [[microscope]], the above are essentially identically; however, the associations (and prognosis) are quite different!

Revision as of 16:26, 19 October 2011

Paget disease of the breast, also Paget's disease of the breast and Paget disease of the nipple, is a thingy seen in the breast. It is abbreviated PDB.[1]

There is also a Paget disease of the bone - just to make things confusing. This is dealt with in the bone article and has nothing (from a pathologic perspective) to do with the Paget disease discussed in this article; these two things just happened to be discovered by the same guy.

Non-bone Paget disease is subdivided into:

  1. Mammary Paget disease - dealt with in this article.
  2. Extramammary Paget disease.

Histologically, i.e. under the microscope, the above are essentially identically; however, the associations (and prognosis) are quite different!

General

  • Cells in the epithelium, i.e. skin, that look like they don't belong.
  • Associated with underlying invasive breast carcinoma.[2]

Note:

Microscopic

Features:[2]

  • Epitheliod morphology (round/ovoid).
  • Cells nested or single.
  • Clear/pale cytoplasm key feature - may also be eosinophilic.
  • Large nucleoli.

Images:

DDx

IHC

Panel:[2]

  • S-100 -ve, HMB-45 -ve (both typically +ve in melanoma).
  • CK7 +ve. (???)
    • Toker cells CK7 +ve.[4]
  • CEA +ve (-ve in Bowen's disease, -ve in Toker cells).

Additional:

  • HER2/neu - usually +ve.
  • CK5/6 -ve.[5]
    • Usu. +ve in squamous cell carcinoma.

See also

References

  1. ↑ Ellis, PE.; Maclean, AB.; Crow, JC.; Wong Te Fong, LF.; Rolfe, KJ.; Perrett, CW. (Dec 2009). "Expression of cyclin D1 and retinoblastoma protein in Paget's disease of the vulva and breast: an immunohistochemical study of 108 cases.". Histopathology 55 (6): 709-15. doi:10.1111/j.1365-2559.2009.03434.x. PMID 19919588.
  2. ↑ 2.0 2.1 2.2 URL: http://emedicine.medscape.com/article/1101235-diagnosis
  3. ↑ URL: http://derm101.com/searchResults.aspx?searchStr=apocrine+carcinoma&rootTerm=apocrine+carcinoma&searchType=2&rootID=12687. Accessed on: 9 September 2011.
  4. ↑ Nofech-Mozes, S.; Hanna, W.. "Toker cells revisited.". Breast J 15 (4): 394-8. doi:10.1111/j.1524-4741.2009.00743.x. PMID 19601945.
  5. ↑ RS. May 2010.
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