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