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患者男,83岁。左侧腋窝红斑伴瘙痒6年。多次按湿疹治疗,无效;3年前始皮损伴轻度疼痛,瘙痒明显,反复破溃不能愈合。近日来皮损增大明显,予手术切除。切除物组织病理示:表皮轻度角化过度,表皮全层可见单个或成巢的Paget细胞,真皮浅层较多淋巴细胞浸润;AB染色(+),PAS染色(-);免疫组化示:CK7,CK8/18,CEA和Ki67均(+);S100和HMB45均(-)。诊断:乳房外Paget病。
Male patient, 83 years old. Left armpit erythema with itching 6 years. Repeatedly according to eczema treatment, invalid; 3 years ago the beginning of the lesion with mild pain, itching was obvious, repeated ulceration can not heal. Lesions increased significantly in recent days, to be surgically removed. Histopathology showed that the epidermis was mildly hyperkeratinated. Paget cells in single or nested cells were found in all layers of the epidermis with infiltration of more lymphocytes in the superficial dermis; AB staining (+) and PAS staining (-); immunohistochemistry : CK7, CK8 / 18, both CEA and Ki67 (+); both S100 and HMB45 (-). Diagnosis: Extramammary Paget’s disease.