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患者男,65岁。阴囊部红斑伴瘙痒11年余。曾多次以湿疹治疗,无明显好转。4个月前出现糜烂、渗出,并伴有明显恶臭,予以手术切除。皮损组织病理:表皮内可见呈巢的Paget细胞,真皮可见累及,基底部皮损未发现肿瘤细胞,切缘见肿瘤累及。免疫组化:CKL(+),CEA(+),Melan A(-),HMB-45(-),EMA(+),GCDEP(+),CK5/6(-),CK7(+),CK20(-),p53(+),p63(-),ki67阳性率约10%~20%。诊断:乳房外Paget病。
Male patient, 65 years old. Scrotal erythema with itching more than 11 years. Has repeatedly treated with eczema, no significant improvement. 4 months ago erosion, exudation, and accompanied by significant stench, to be surgically removed. Pathological changes of the lesion: Paget cells were seen in the epidermis, with visible involvement in the dermis. No tumor cells were found in the basal lesion and the tumor was found in the cut edge. Immunohistochemistry: CKL +, CEA +, Melan A -, HMB-45 (-), EMA (+), GCDEP +, CK5 / 6, (-), p53 (+), p63 (-), ki67 positive rate of about 10% to 20%. Diagnosis: Extramammary Paget’s disease.