TY - JOUR
T1 - Pigmented paget disease - A diagnostic pitfall mimicking melanoma
AU - Petersson, Fredrik
AU - Ivan, Doina
AU - Kazakov, Dmitry V.
AU - Michal, Michal
AU - Prieto, Victor G.
PY - 2009/5
Y1 - 2009/5
N2 - Pigmented mammary and extramammary Paget disease are rare entities in both males and females that mimic melanoma both clinically and histologically. Furthermore, Paget disease can be associated with increased number of benign melanocytes, thus resulting in additional diagnostic difficulty, especially when only hematoxylin and eosin-stained sections are examined and a limited immunohistochemical study is performed. Using standard hematoxylin and eosin-stained sections and routine immunohistochemical studies, we describe and characterize 7 cases of pigmented extramammary and mammary Paget disease. In all cases, malignant epithelial cells showed intracytoplasmic pigment, along with an immunohistochemical epithelial phenotype. In 2 of the cases, immunohistochemistry revealed numerous dendritic processes positive for melanocytic markers, thus resulting in an initial diagnosis of melanoma. Careful analysis confirmed that the immunolabeling corresponded to cytoplasmic labeling of melanocyte dendrites surrounding tumor cells. The correct diagnosis of pigmented Paget disease can be reached after close histologic examination and detailed evaluation of immunohistochemical studies. The latter are especially important in some extraordinary cases in which there may be an associated intraepithelial melanocytic hyperplasia.
AB - Pigmented mammary and extramammary Paget disease are rare entities in both males and females that mimic melanoma both clinically and histologically. Furthermore, Paget disease can be associated with increased number of benign melanocytes, thus resulting in additional diagnostic difficulty, especially when only hematoxylin and eosin-stained sections are examined and a limited immunohistochemical study is performed. Using standard hematoxylin and eosin-stained sections and routine immunohistochemical studies, we describe and characterize 7 cases of pigmented extramammary and mammary Paget disease. In all cases, malignant epithelial cells showed intracytoplasmic pigment, along with an immunohistochemical epithelial phenotype. In 2 of the cases, immunohistochemistry revealed numerous dendritic processes positive for melanocytic markers, thus resulting in an initial diagnosis of melanoma. Careful analysis confirmed that the immunolabeling corresponded to cytoplasmic labeling of melanocyte dendrites surrounding tumor cells. The correct diagnosis of pigmented Paget disease can be reached after close histologic examination and detailed evaluation of immunohistochemical studies. The latter are especially important in some extraordinary cases in which there may be an associated intraepithelial melanocytic hyperplasia.
KW - Immunohistochemistry
KW - Melanoma
KW - Pigmented Paget disease
UR - http://www.scopus.com/inward/record.url?scp=66149103608&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=66149103608&partnerID=8YFLogxK
U2 - 10.1097/DAD.0b013e3181930dc6
DO - 10.1097/DAD.0b013e3181930dc6
M3 - Article
C2 - 19384061
AN - SCOPUS:66149103608
SN - 0193-1091
VL - 31
SP - 223
EP - 226
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 3
ER -