阴囊Paget病的临床病理研究

目的 探讨阴囊Ｐａｇｅｔ病的临床特点与影响预后的因素。方法 对１１例Ｐａｇｅｔ特病患者的临床病理资料进行回顾性研究。结果 阴囊Ｐａｇｅｔ病易累及毛囊和汗腺但不易发生转移。扩大的病灶切除术是原发及局部再发Ｐａｇｅｔ病治疗的首选方法。１０例患者平均随访３８．６个月,无死亡病例。

Clinicopathologic study of 11 patients with Paget's disease of scrotum

Objective To probe the relationship of clinicopathologic presentations and prognosis of Pagets disease primarily involving the scrotum. Methods 11 cases of scrotal Pagets disease were studied retrospectively from 1984 to 1997. PAS was stained and EMA, S100, HMB45, CEA and CA153 were immunostained in all cases for the differential diagnosis from Bowens disease and malignant melanoma. Results Six of 11 cases involved hair follicle and/or sweat glands, and 3 cases involved dermis (one had metastasis of left superficial and deep inguinal lymph nodes, and left internal iliac lymph nodes). Pagets cells were positive for PAS(11/11), EMA(11/11), CEA(6/11), CA153(11/11), and negative for S100, HMB45. Wide local excision of the lesions was perfomed in 10 of 11 patients both for primary disease and recurrent disease. 3 of the 10 patients underwent lymph nodes resection and metastasis was found in 1 case pathologically. One patient accepted chemotherapy and died, from respiratory insuficiency after one month. The other 10 patients were followed up for 6 to 127 months and no patient died of Pagets disease. Conclusions Involvement of hair follicles and sweat glands by Pagets cell does not influence the prognosis.However, invasion of dermis by Pagets cells may suggest possible metastasis.