14例Paget病临床及病理特征分析

Paget's disease:clinical and pathological analyses on 14 cases

目的:分析Paget病的临床及组织病理学特征。方法:回顾性分析14例Paget病患者的临床及病理资料。结果:男6例,女8例;平均年龄58±3.58岁;平均病程32.31±29.63个月。发生在龟头1例;腋下1例;乳房5例;阴囊5例,其中累及阴茎3例;女性外阴2例。11例患者皮损为红斑,伴有浸润、糜烂和结痂。3例患者仅为红斑,表面附有少量白色鳞屑。10例患者在疾病初期均误诊为湿疹。组织病理均具有典型的Paget细胞。免疫组化显示所有患者CK7均阳性、CK20阴性、EMA12例阳性,CEA13例阳性。所有患者均未并发其他肿瘤。结论:Paget病易误诊为湿疹,免疫组化检查具有辅助诊断价值。

Objective：To characterize the clinical and pathological profiles of 14 patients with Paget＇ s disease.Methods：The clinical and histopathologic characteristics of 14 patients with Paget＇s disease were retrospectively analyzed.Results：There were 6 males and 8 females.The age ranged from 36 to 78 years （mean 58±3.58 years）.The tumor was located in scrotum in 5 patients,penis in 3,glans 1,subaxilla 1,breasts 5 and female genital areas 2.The lesions were erythema,infiltration,erosion and crusting in eleven patients only showed erythema with a small amount of white scale in 3 ptients.Ten patients were misdiagnosed as eczema.Typical Paget cells were seen in all the patients.Histopathologic staining showed CK7 positivity in 14 cases （100％）,EMA in 12 cases,CEA in 13 cases.CK20 was negative in all patients.All patients were not complicated with other tumors.Conclusion：Paget＇ s disease was easily misdiagnosed as eczema and immunohistochemistry has assistant diagnostic value.