并发乳腺癌的乳房Paget病

Two cases of mammary Paget's disease with breast cancer

报告2例并发乳腺癌的乳房Paget病。患者均为老年女性,临床上均表现为左侧乳头及乳晕红斑、糜烂及结痂等湿疹样损害。皮损组织病理表现为表皮内有大的、空泡化的、成巢状分布的肿瘤细胞。免疫组化:(例1)癌胚抗原(CEA)(+)、角蛋白(CK)7(+)、表皮生长因子受体(CerbB)-2(0065)(+)、囊泡病液体蛋白(GCDFP)-15灶性(+)、雌激素受体(ER)(-)、HMB45(-)、P53(+);(例2)CK7(+)、GCDFP-15灶性(+)、P53(+)、ER(+)。乳腺癌术后组织病理:(例1)乳腺导管内癌(高级别,多灶),伴乳头皮肤Paget病,皮肤切缘净,腋窝淋巴结未见癌转移(0/7)。免疫组化结果显示:高分子量角蛋白(34βE)12(+)、细胞增殖抗原(Ki)-67(约10%+)、P53(约85%+)、导管壁肌上皮(P63)(+)、拓扑异构酶2(TOPOⅡ)<1%(+);(例2)左乳腺浸润性导管癌(中分化)伴乳腺皮肤Paget病,脉管内可见癌栓,淋巴结可见癌转移(腋窝淋巴结22/28)。免疫组化结果显示:CD31(+)、CerbB-2(0041)(+)、E-cadherin(+)、ER(约20%中度+)、Ki-67(<5%+)、P53(50%～60%+)、TOPOⅡ(约1%+)、P120(膜+)。

Two eases of mammary. Paget＇s disease with breast cancer are reported. They are both female. The eruptions presented as erythema, erosion, scabs, eczema-like lesions involving the nipple and areola of their left breast. The histopathol- ogy was manifested as an intraepidermal proliferation of large epithelioid ceils. The cytoplasm showed varying degrees of vae- uolization. Immunohistochemical studies demonstrated that the tumor cells of the first patient were positive for CEA, CKT, CerbB-2（OO65）,GCDFP-15 and P53. The second were positive for CK7, GCDFP-15, P53 and ER. The result of histopalhol- ogy after mastectomy shown that the first patient was Ductal careinoma and the second was Invasive duetal carcinoma with lymph node metastasis. The Breast cancer cells of the first patient were positive for 3413E12, ER, Ki-67, P53, P63, TOPO II, and the cells of the second were positive for CD31, CerbB-2（0041）, E-cadherin, ER, Ki-67, P53, TOPOII , PI20.