653
edits
Difference between revisions of "Extramammary Paget disease"
Jump to navigation
Jump to search
→IHC
(→DDx) |
(→IHC) |
||
| Line 102: | Line 102: | ||
*Is the lesion adenocarcinoma or squamous cell carcinoma? | *Is the lesion adenocarcinoma or squamous cell carcinoma? | ||
**Low molecular weight (CK7, cam5.2) or high molecular weight keratins (34BE12, CK5/6)? | **Low molecular weight (CK7, cam5.2) or high molecular weight keratins (34BE12, CK5/6)? | ||
***Don't rely entirely on the cytokeratin profile | |||
***Pagetoid squamous cell carcinoma in situ can lose HMW keratins and produce a LMW profile. | |||
**Adenocarcinoma markers? - CEA, BerEP4 | **Adenocarcinoma markers? - CEA, BerEP4 | ||
**Nuclear differentiation markers? - p63 (squamous) vs GATA3 (adnexal) | **Nuclear differentiation markers? - p63 or p40 (squamous) vs GATA3 (adnexal) | ||
*Is the lesion primary or secondary? | *Is the lesion primary or secondary? | ||
**Secondary extramammary Paget disease may be CK20 positive (urothelial or rectal) | **Secondary extramammary Paget disease may be CK20 positive (urothelial or rectal) | ||
| Line 114: | Line 116: | ||
*CK7 and CK20 - where does it come from? | *CK7 and CK20 - where does it come from? | ||
*S100 and Melan A - exclude melanoma in situ | *S100 and Melan A - exclude melanoma in situ | ||
*Differentiation markers; GATA - apocrine and urothelial, p63 - squamous, CDX2 - colorectal | *Differentiation markers; GATA - apocrine and urothelial, p63 and p40 - squamous, CDX2 - colorectal | ||
*Notice urothelial origin Paget can show immunos patterns "transitional" between glandular and squamous epithelium | *Notice urothelial origin Paget can show immunos patterns "transitional" between glandular and squamous epithelium | ||