腫瘤を形成した乳房外 Paget 病の1例 : 腫瘤部と局面部の Paget 細胞および周囲の表皮ケラチノサイトのケラチン発現パターン

概要

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A 64-year-old man noted an erythematous plaque on his scrotum almost 30 years ago. The center of the lesion gradually elevated with papillomatous surface in recent several years. Physical examination revealed fist-sized erythematous plaque with dyschromatosis and some finger head-sized papillomatous nodes on the scrotum and dorsal surface of the penis. The biopsy of the lesion confirmed the diagnosis of extramammary Pagets disease. Wide excision of the lesion including inguinal lymph node dissection were conducted. Histologically, the node showed acanthosis with mild papillomatosis, and Paget cells proliferated in the lower epidermis and focally in the dermis, while the plaque did not show any acanthotic changes. Nodules with verrucous surface displayed anastmosing downward proliferation of epidermis containing sparse Paget cells. Immunohistochemically, in situ and dermal Paget cells expressed K7, K8, K8/18, K10/11, K18, and K19, while they failed to express K1, K4, K13, K14, K17, and K20. The epidermal keratinocytes in the plaque expressed the same keratin as normal skin. Whereas, in the node basal keratinocytes expressed K10/11, K13, K17, and suprabasal keratinocytes reacted with K17. These data indicate that the proliferation of Paget cells could alter the expression of cytokeratins in neighboring keratinocytes.
日本皮膚悪性腫瘍学会の論文
1997-06-30