title: Characteristics of clear cells and Toker cells in the epidermis of underlying nipple duct adenoma.
abstract: Clinically, it is difficult to differentiate between nipple duct adenomas (NDAs) and Paget's disease of the nipple. These lesions share similar morphological and histological characteristics. Clear cell types present in NDA, epidermal clear cells (ECC) and Toker cells (TC), share immunoreactive similarities to Paget cells which can lead to confusion in classification. The aim of this study was to obtain information on the characteristics and histogenesis of ECC and TC, to distinguish these cells from Paget cells. Ten nipple epidermal with NDA were compared to 25 histologically normal nipples. Samples were analyzed for cytokeratins (CKs) 7, 8 and 18, carcinoembryonic antigen (CEA), c-erbB-2/HER2 expression and human papillomavirus (HPV-) DNA. In 13 out of 25 normal nipples the staining sequence demonstrated that ECC and TC cell types are immunoreactive with CKs 7, 8 and 18 in the basal region of the epidermis. In contrast, aggregated CKs 7, 8 and 18-immunoreactive ECC and TC were identified in the epidermal of 8 of the 10 NDA cases. In 2 cases, TC were continuous with the underlying NDA, suggesting that TC might be of ductal origin and migrate through the galactophorous ostia. In NDAs and 25 histologically normal nipples, ECC and TC were negative for CEA, c-erbB-2/HER2 and HPV-DNA. ECC and TC, normally present in the nipple epidermis, may proliferate and form aggregates in the presence of an underlying NDA. These cells show immunoreactivity for CKs 7, 8 and 18 but are negative for c-erbB-2/HER2, CEA and HPV-DNA and should not lead to the mistaken diagnosis of Paget's disease.
authors.affiliation: Department of Gynecology and Obstetrics, Division of Special Gynecology, University of Vienna, Wahringer Gurtel 18-20, A-1090 Vienna, Austria. mahmood_manavi@hotmail.com
authors.forename: Mahmood
authors.initials: M
authors.lastname: Manavi
authors.forename: Gernot
authors.initials: G
authors.lastname: Hudelist
authors.forename: Christian
authors.initials: C
authors.lastname: Schatten
authors.forename: Walter B
authors.initials: WB
authors.lastname: Battistutti
authors.forename: Kerstin I D
authors.initials: KI
authors.lastname: Pischinger
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Czerwenka
mesh_terms: D000199:Actins / Q000096:biosynthesis; D000236:Adenoma / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000096:biosynthesis; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007633:Keratins / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009558:Nipples / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics; D016133:Polymerase Chain Reaction / Q000379:methods; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis
chemical_list: D000199:Actins; D002272:Carcinoembryonic Antigen; D004279:DNA, Viral; D007633:Keratins; D018719:Erb-b2 Receptor Tyrosine Kinases