悪性悪色腫との鑑別が困難であった乳房Ｐａｇｅｔ病の１例

• 森川 政夫

  大阪医科大学中央検査部病理

• 山本 隆一

  大阪医科大学中央検査部病理

• 黒川 彰夫

  大阪医科大学中央検査部病理

• 橋本 和明

  済生会吹田病院

• 辻 求

  市立伊丹病院

• 清水 章

  大阪医科大学中央検査部病理

書誌事項

タイトル別名

• A case of Paget's disease resembling malignant melanoma.

抄録

A case of Paget's disease showing peculiar cytological features which could be confused with those of malignant melanoma is reported. A 59-year-old woman was admitted to our hospital because of itching and discharge from the right nipple. Smear cytology showed large and sparsely aggegated atypical cells with abundant basophilic cytoplasm where significant amounts of melanin granules were found. Some non-neoplastic dendritic melanocytes and many inflammatory cells were also identified.<BR>The histological examination of the biopsied nipple revealed large atypical cells with pale basophilic cytoplasm in the epidermis of the right nipple. The tumor cells showed marked nuclear atypism and had significant amounts of cytoplasmic melanin granules. They tended to gather into small cell nests accompanying non-neoplastic dendritic melanocytes. Immunohistochemical examination revealed the tumor cells to be negative for carcinoembryonic antigen (CEA), cytokeratins, and equivocal for S-100 protein. Immunoperoxidase staining for anti-human melanoma antibody (HMB 45) and the tissue DOPA reaction test were negative. Simple mastectomy was done and the resected breast tissue showed typical features of Paget's disease.<BR>The Paget's cells in our case had significant amounts of melanin granules in the cytoplasm. We know that the Paget's cell occasionally has cytoplasmic melanin granules, but with significant pigmentation, such as in our case, it is difficult to distinguish from malignant melanoma on routine examination. In addition to immunoperoxidase staining for HMB 45 and the tissue DOPA reaction test, the authors emphasize that identyfying the coexistence of normal melanocytes is a good supportive finding for the cytopathological diagnosis of Paget's disease. Normal melanocytes can be found using a routine Papanicolaou stain or hematoxylin and eosin stain, and are rarely found in malignant melanoma.

収録刊行物

• 日本臨床細胞学会雑誌

  日本臨床細胞学会雑誌 34 (6), 1139-1143, 1995

  公益社団法人　日本臨床細胞学会

キーワード

• Breast
• Cytology
• Paget's disease
• Case report

詳細情報

• CRID: 1390001204692727424
• NII論文ID: 130003926242
• DOI: 10.5795/jjscc.34.1139
• ISSN: 18827233
• ISSN: 03871193
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可