title: Gross cystic disease fluid protein-15 reactivity in extramammary Paget's disease with and without associated internal malignancy.
abstract: Extramammary Paget's disease (EMP) is a rare eczematoid disorder occurring mainly in apocrine-gland-bearing regions. Its histogenesis is controversial. Several investigators have proposed that EMP is a heterologous entity, with some cases representing a de novo adenocarcinoma in situ arising in the epidermis and others being epidermotropic metastases or a direct extension of an associated internal malignancy. We have studied 26 cases of EMP with and without associated internal malignancy for their reactivity with a monoclonal antibody directed at gross cystic disease fluid protein-15 (GCDFP-15). The diagnosis of EMP has been previously established for all cases using histochemical and immunohistochemical stains. Six of our 26 cases had a concomitant underlying carcinoma (one transitional cell carcinoma of the bladder, four adenocarcinomas of the rectum, one adenosquamous carcinoma. Only one of these six cases showed reactivity with GCDFP-15. In contrast, 16 of 20 cases of EMP without associated internal malignancy were strongly reactive with GCDFP-15 (> 5% of tumor cells). Variable GCDFP-15 reactivity in cases of EMP with and without associated internal malignancy supports the concept that EMP is a heterologous disorder. Positive GCDFP-15 in a patient with EMP may indicate a low probability of associated internal malignancy and may provide valuable clinical information.
authors: Department of Pathology, Stanford University Medical Center, CA 94305, USA.
authors: S
authors: S
authors: Kohler
authors: B R
authors: BR
authors: Smoller
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000175:diagnosis / Q000473:pathology; D001050:Apocrine Glands / Q000473:pathology; D001053:Apolipoproteins; D053399:Apolipoproteins D; D014408:Biomarkers, Tumor / Q000032:analysis*; D002278:Carcinoma in Situ / Q000473:pathology; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis / Q000473:pathology; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology; D002352:Carrier Proteins / Q000032:analysis*; D004439:Eccrine Glands / Q000473:pathology; D005260:Female; D006023:Glycoproteins / Q000032:analysis*; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D026901:Membrane Transport Proteins; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology*; D010145:Paget Disease, Extramammary / Q000175:diagnosis / Q000473:pathology*; D011336:Probability; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology
chemical_list: C024328:APOD protein, human; D001053:Apolipoproteins; D053399:Apolipoproteins D; D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D006023:Glycoproteins; D026901:Membrane Transport Proteins; D009363:Neoplasm Proteins; C488892:PIP protein, human