乳房Paget病误诊一例

Misdiagnosis of mammary Paget’s disease:a case report

53岁女性患者,右侧乳头、乳晕反复红斑、渗出和结痂3年。3年前患者右侧乳头和乳晕出现红斑、渗出及结痂,曾按湿疹治疗。23个月前,组织病理学诊断为湿疹。皮肤科情况:右侧乳头、乳晕可见面积约3.5 cm^2红斑,表面可见痂屑,同侧乳头萎缩。组织病理示:表皮内较多异形肿瘤细胞,散在或呈巢团状分布,瘤细胞圆形或卵圆形,胞体大、胞质丰富淡染,核仁明显,可见核分裂像。诊断:乳房Paget病。患者接受了乳腺癌改良根治术,随诊14个月,未见复发。

A 53-year-old female patient who was misdiagnosed as eczema with recurrent erythema,exudation and crust on her right nipple and areola for 3 years was reported.Three years ago,erythema,exudation and curst developed on the right nipple and areola of the patient and was once treated as eczema.A biopsy was performed 23 months ago and the histopathology diagnosis was eczema too.Physical exam showed that there was a erythema about 3.5 cm^2 around right nipple and areola,with scales and scabs on the surface,complicated with ipsilateral nipple atrophy.The histopathology showed that there were many heteromorphic tumor cells scattered or nested in the epidermis.The tumor cells were round or oval,large in size,abundant in cytoplasm and stained with obvious nucleoli,and mitotic figures could be seen.Diagnosis:mammary Paget's disease.The patient underwent modified radical mastectomy for breast cancer and was followed up for 14 months without recurrence.