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.
#redirect [[Paget's disease of the breast]]
 
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:
#Mammary Paget disease.
#Extramammary Paget disease.
 
Histologically, i.e. under the [[microscope]], the above are essentially identically; however, the associations (and prognosis) are quite different!
 
==Mammary Paget disease==
===General===
*Cells in the epithelium, i.e. skin, that look like they don't belong.
*Associated with underlying breast carcinoma.<ref name=emed_pagets>URL: [http://emedicine.medscape.com/article/1101235-diagnosis http://emedicine.medscape.com/article/1101235-diagnosis]</ref>
 
Note:
*Extra-mammary Paget's disease is not assoc. with malignancy.
 
===Microscopic===
Features:<ref name=emed_pagets/>
*Epitheliod morphology (round/ovoid).
*Cells nested or single.
*Clear/pale cytoplasm '''key feature''' - may also be eosinophilic.
*Large nucleoli.
 
Images:
*[http://commons.wikimedia.org/wiki/File:Extramammary_Pagets_disease_low.jpg Paget's disease - low mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Extramammary_Pagets_disease_high.jpg Paget's disease - high mag. (WC)].
 
===DDx===
*Benign Toker cell hyperplasia.
*[[Malignant melanoma]].
*Bowen disease.
 
*Nipple duct adenoma (clinical DDx).
 
===IHC===
Panel:<ref name=emed_pagets/>
*S-100 -ve, HMB-45 -ve (both typically +ve in melanoma).
*CK7 +ve
*CEA +ve (-ve in Bowen's disease, -ve in Toker cells).
 
Additional:
*HER2/neu - usually +ve.
*CK5/6 -ve.<ref>RS. May 2010.</ref>
**Usu. +ve in squamous cell carcinoma.
 
==Extramammary Paget disease==
===General===
*Usually not associated with malignancy.
 
===Microscopic===
Features:
*Indistinguishable from mammary paget's disease.
**See ''Microscopic'' section in ''mammary Paget's disease''.
 
==See also==
*[[Breast]].
*[[Invasive breast cancer]].
 
==References==
{{Reflist|2}}
 
[[Category:Breast pathology]]

Latest revision as of 02:11, 11 September 2014

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