title: Mammary Paget's disease and associated carcinoma. An immunohistochemical study.
abstract: Mammary Paget's disease has been said to result from epidermal spread by contiguity of primary intraductal carcinoma. To assess similar identity, we immunostained Paget's cells and underlying intraductal and/or invasive mammary carcinoma in 20 cases for cytokeratins, epithelial membrane antigen, gross cystic disease fluid protein-15, lysozyme, carcinoembryonic antigen, S100 protein, kappa-casein, and alpha-lactalbumin. Steroid receptor immunostain was positive in only one (5%) of the cases of Paget's disease and in two and four (approximately 15%) (for estrogen and progesterone receptor, respectively) of the cases of ductal carcinoma. In 18 patients (90%), the immunohistochemical profile was identical in Paget's cells and associated carcinoma for seven or more antigens. In one patient, there was a definite disparity in the antigenic profile; in another patient, this was dissimilar because of very focal staining in one site. The antigenic similarity between Paget's cells and underlying carcinoma in 18 (90%) of the cases of mammary Paget's disease suggested in favor of their common origin, ie, probably intraepidermal spread of ductal carcinoma. Origin from apocrine/eccrine structures, or multipotent cells in the epidermis, was suggested in a minority.
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Ga.
authors.forename: C
authors.initials: C
authors.lastname: Cohen
authors.forename: J
authors.initials: J
authors.lastname: Guarner
authors.forename: P B
authors.initials: PB
authors.lastname: DeRose
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000737:chemistry*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008562:Membrane Glycoproteins / Q000032:analysis; D018396:Mucin-1; D010144:Paget's Disease, Mammary / Q000737:chemistry*; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D008562:Membrane Glycoproteins; D018396:Mucin-1; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D009418:S100 Proteins; D007633:Keratins