Spectrum of Changes in Anogenital Mammary-like Glands in Primary Extramammary (Anogenital) Paget Disease and Their Possible Role in the Pathogenesis of the Disease

被引:15
作者
Konstantinova, Anastasia M. [1 ,2 ,3 ]
Spagnolo, Dominic V. [5 ,6 ]
Stewart, Colin J. R. [7 ]
Kacerovska, Denisa [8 ,9 ]
Shelekhova, Ksenya V. [1 ,3 ]
Plaza, Jose A. [11 ]
Suster, Saul [12 ]
Bouda, Jiri [10 ]
Kyrpychova, Liubov [8 ]
Michal, Michal [8 ,9 ]
Belousova, Irena E. [1 ,3 ,4 ]
Kerl, Katrin [13 ]
Kazakov, Dmitry V. [8 ,13 ]
机构
[1] Clin Res & Pract Ctr Specialized Oncol Care, Dept Pathol, St Petersburg, Russia
[2] St Petersburg State Univ, Med Fac, Dept Pathol, St Petersburg, Russia
[3] St Petersburg Medicosocial Inst, Dept Pathol, St Petersburg, Russia
[4] Mil Med Acad, Dept Dermatol, St Petersburg, Russia
[5] QEII Med Ctr, PathWest Lab Med WA, Nedlands, WA, Australia
[6] Univ Western Australia, Sch Pathol & Lab Med, Nedlands, WA, Australia
[7] King Edward Mem Hosp, PathWest Lab Med WA, Perth, WA, Australia
[8] Charles Univ Prague, Med Fac Pilsen, Sikls Dept Pathol, Prague, Czech Republic
[9] Charles Univ Prague, Med Fac Hosp, Biopt Lab, Plzen, Czech Republic
[10] Charles Univ Prague, Med Fac Hosp, Dept Obstet & Gynecol, Plzen, Czech Republic
[11] Miraca Life Sci, Irving, TX USA
[12] Med Coll Wisconsin, Div Dermatopathol, Dept Pathol, Milwaukee, WI 53226 USA
[13] Zurich Univ Hosp, Dept Dermatol, Dermatopathol Unit, Zurich, Switzerland
关键词
anogenital mammary-like glands; extramammary Paget disease; vulva; columnar cell change; columnar cell hyperplasia; ductal hyperplasia; mammary-type carcinoma; CLEAR CELLS; BREAST-CARCINOMA; ADENOCARCINOMA; LESIONS; TOKER; VULVA; PAPILLIFERUM; HISTOGENESIS; INVOLVEMENT; DERIVATION;
D O I
10.1097/PAS.0000000000000857
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
To determine whether a subset of primary extramammary Paget disease (EMPD) may originate in anogenital mammary-like glands (AGMLG), the authors studied 181 specimens of EMPD, detailing alterations in AGMLG. The latter were identified in 33 specimens from 31 patients. All patients were women, ranging in age from 38 to 93 years (median, 65 y). In all cases, lesions involved the vulva and in 1 patient the perianal skin was affected. Histopathologically, AGMLG manifested changes identical to columnar cell change (CCC) (87.1%), usual ductal hyperplasia (22.6%), columnar cell hyperplasia (CCH) (9.7%), oxyphilic (apocrine) metaplasia (6.5%), and atypical duct hyperplasia (3.2%). Four cases (12.9%), in addition to intraepidermal carcinoma, harbored invasive carcinoma. In all 4 of these, AGMLG displayed a range of alterations including ductal carcinoma in situ, CCC, and CCH. Three further cases (9.7%) showed ductal carcinoma in situ without any definite invasive carcinoma. Colonization of AGMLG by neoplastic Paget cells was noted in 6 cases. As CCC and CCH may be encountered in normal AGMLG, these alterations are unlikely to play a significant role in the pathogenesis of the disease. However, by analogy with mammary Paget disease, rare cases of primary EMPD may originate in AGMLG with a subsequent upward migration of the neoplastic cells into the epidermis and possible later breach through the basal membrane. Usual ductal hyperplasia and atypical duct hyperplasia can then be regarded as earlier precursor lesions, linking both ends of the spectrum.
引用
收藏
页码:1053 / 1058
页数:6
相关论文
共 36 条
[1]   Vulvar toker cells: The long-awaited missing link - A proposal for an origin-based histogenetic classification of extramammary Paget disease [J].
Belousova, Irena E. ;
Kazakov, Dmitry V. ;
Michal, Michal ;
Suster, Saul .
AMERICAN JOURNAL OF DERMATOPATHOLOGY, 2006, 28 (01) :84-86
[2]   Molecular alterations in columnar cell lesions of the breast [J].
Dabbs, DJ ;
Carter, G ;
Fudge, M ;
Peng, Y ;
Swalsky, P ;
Finkelstein, S .
MODERN PATHOLOGY, 2006, 19 (03) :344-349
[3]   AGGRESSIVE BREAST-LIKE ADENOCARCINOMA OF VULVA [J].
DIBONITO, L ;
PATRIARCA, S ;
FALCONIERI, G .
PATHOLOGY RESEARCH AND PRACTICE, 1992, 188 (1-2) :211-214
[4]   Invasive Paget Disease of the Breast Clinicopathologic Study of an Underrecognized Entity in the Breast [J].
Duan, Xiuzhen ;
Sneige, Nour ;
Gullett, Ashley E. ;
Prieto, Victor G. ;
Resetkova, Erika ;
Andino, Lizmarie M. ;
Wu, Yun ;
Gilcrease, Micharl Z. ;
Bedrosian, Isabelle ;
Dawood, Shaheenah ;
Arun, Banu ;
Albarracin, Constance T. .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2012, 36 (09) :1353-1358
[5]   VULVAR PAGETS-DISEASE - THE NEED TO EXCLUDE AN INVASIVE LESION [J].
FEUER, GA ;
SHEVCHUK, M ;
CALANOG, A .
GYNECOLOGIC ONCOLOGY, 1990, 38 (01) :81-89
[6]   HISTOGENESIS OF EXTRAMAMMARY AND MAMMARY PAGET CELLS - AN IMMUNOHISTOCHEMICAL STUDY [J].
GUARNER, J ;
COHEN, C ;
DEROSE, PB .
AMERICAN JOURNAL OF DERMATOPATHOLOGY, 1989, 11 (04) :313-318
[7]   EXTRAMAMMARY PAGET CELLS - FURTHER EVIDENCE OF SWEAT GLAND DERIVATION [J].
HAMM, H ;
VROOM, TM ;
CZARNETZKI, BM .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1986, 15 (06) :1275-1281
[8]   IMMUNOHISTOCHEMICAL STAINS IN EXTRAMAMMARY PAGETS-DISEASE [J].
HELM, KF ;
GOELLNER, JR ;
PETERS, MS .
AMERICAN JOURNAL OF DERMATOPATHOLOGY, 1992, 14 (05) :402-407
[9]   Lesions of Anogenital Mammary-like Glands: An Update [J].
Kazakov, Dmitry V. ;
Spagnolo, Dominic V. ;
Kacerovska, Denisa ;
Michal, Michal .
ADVANCES IN ANATOMIC PATHOLOGY, 2011, 18 (01) :1-28
[10]  
Kazakov DV., 2012, Cutaneous adnexal tumors