Difference between revisions of "Paget disease of the breast"
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Revision as of 16:27, 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:
- Mammary Paget disease - dealt with in this article.
- 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:
- Extramammary Paget's disease is not usually associated with malignancy.
Microscopic
Features:[2]
- 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).
- Apocrine carcinoma.[3]
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
- ↑ 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.
- ↑ 2.0 2.1 2.2 URL: http://emedicine.medscape.com/article/1101235-diagnosis
- ↑ URL: http://derm101.com/searchResults.aspx?searchStr=apocrine+carcinoma&rootTerm=apocrine+carcinoma&searchType=2&rootID=12687. Accessed on: 9 September 2011.
- ↑ 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.