Difference between revisions of "Paget disease of the breast"
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Panel:<ref name=emed_pagets/> | Panel:<ref name=emed_pagets/> | ||
*S-100 -ve, HMB-45 -ve (both typically +ve in melanoma). | *S-100 -ve, HMB-45 -ve (both typically +ve in melanoma). | ||
*CK7 +ve | *CK7 +ve. (???) | ||
**Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month = | year = | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref> | |||
*CEA +ve (-ve in Bowen's disease, -ve in Toker cells). | *CEA +ve (-ve in Bowen's disease, -ve in Toker cells). | ||
Revision as of 14:06, 2 September 2011
Paget disease of the breast, also Paget's disease of the breast, is a thingy seen in the breast... and elsewhere - except bone.
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!
General
- Cells in the epithelium, i.e. skin, that look like they don't belong.
- Associated with underlying invasive breast carcinoma.[1]
Note:
- Extramammary Paget's disease is not usually associated with malignancy.
Microscopic
Features:[1]
- Epitheliod morphology (round/ovoid).
- Cells nested or single.
- Clear/pale cytoplasm key feature - may also be eosinophilic.
- Large nucleoli.
Images:
DDx
- Benign Toker cell hyperplasia.
- Malignant melanoma.
- Bowen disease.
- Nipple (duct) adenoma (clinical DDx).
- Eccrine carcinoma.
IHC
Panel:[1]
- S-100 -ve, HMB-45 -ve (both typically +ve in melanoma).
- CK7 +ve. (???)
- Toker cells CK7 +ve.[2]
- CEA +ve (-ve in Bowen's disease, -ve in Toker cells).
Additional:
- HER2/neu - usually +ve.
- CK5/6 -ve.[3]
- Usu. +ve in squamous cell carcinoma.
See also
References
- ↑ 1.0 1.1 1.2 URL: http://emedicine.medscape.com/article/1101235-diagnosis
- ↑ 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.
- ↑ RS. May 2010.