子宮頸癌に対する放射線照射後に肛門周囲 Paget 病が先行した肛門癌の1例と本邦報告例の検討

概要

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The patient was a 59-year-old woman. Total hysterectomy and irradiation were perfor-med for uterine cervical cancer 25 year previously. Paget's cells resembling signet ring cells were found in the epidermis, and anal cancer was present adjacent to them. The histological diagnosis of the anal cancer was mainly well differentiated adenocarcinoma, but mucinous carcinoma was present containing signet ring cells at sites contiguous with the anal glands, and lymphatic permeation was noted in the dermis.<BR>The cancer and the Paget's cells were both positive for PAS and alcian blue staining and were negative for PB/KOH/PAS staining. Furthermore, such findings as atypia of the glandular ducts and endoarteritis were detected in the underlying mucosa. Therefore, it was considered that this patient had anal cancer derived from the anal glands, that the Paget's cells were due to the intraepidermal extension of signet ring cells, and that the cancer may have been related to her previous irradiation. Reports of cancer of the rectum and anus complicated by Paget's lesion in Japan were reviewed and studied with regard to the histogenesis. It was concluded that peri-anal Paget's lesion had a close relationship with anal cancer derived from the anal glands.