阴囊、阴茎Paget病临床病理分析

目的:探讨阴囊、阴茎Paget病的临床病理特点、诊断及鉴别诊断依据。方法:复习13例阴囊、阴茎Paget病的临床病理资料,采用HE染色、特殊染色(AB/PAS)及免疫组化技术进行观察分析。结果:阴囊、阴茎Paget病以老年男性多见,发病年龄55～84岁,中位年龄为71岁。肉眼皮损呈湿疹样改变。光镜下表皮内可见数目不等的Paget细胞呈单个散在、巢状或条索状分布。所有病例AB/PAS染色均阳性;13例均表达CK7、CEA、EMA抗原,不表达CK5/6、S-100及P63,GCDFP-15与CK20阳性表达率分别为76.92%(10/13)和53.85%(7/13)。结论:阴囊、阴茎Paget病为低度恶性的皮肤上皮性肿瘤,有特殊的临床及组织病理学特点,免疫组化标记有助于该肿瘤的诊断。

Clinicopathological Analysis of Paget's Disease of the Scrotum and Penis

Objective： To investigate the clinical pathological characteristics, diagnosis and differential diagnosis of Paget＇s disease of the scrotum and penis. Methods ： Thirteen cases of Paget＇s disease of the scrotum and penis were analyzed by light microscopy, alcian-blue （AB）/periodie-acid-Schiff （PAS） and immunohistoehemieal staining. Results： Paget＇s disease of the scrotum and penis mainly affected old individuals aged 55-84 （mean 71 ） years. Macroscopically, typical presentations of Paget＇s disease of the scrotum and penis were eczamatoid lesions. Microscopically, Paget cells were distributed singly or in groups （ as strands, nests or glandular patterns） within the epidermis. Paget ceils were typically stained for AB/PAS, positive for CK7, CEA and EMA, and negative for CK5/6, S-100 and P63. The positive rates of GCDFP-15 and CK20 expressions were 76.92% （ 10/13 ） and 53.85% （7/13）, respectively. Conclusion ： Paget＇s disease of the scrotum and penis is a low-malignancy cutaneous tumor with typical clinical and pathological features. Pathologic diagnosis is based on immunohistoehemieal findings.