Ultrastructural Examination of a Case of Pagetoid Bowen Disease Exhibiting Immunohistochemical Features in Common With Extramammary Paget Disease.
A panel of immunohistochemical markers may be used to differentiate between pagetoid Bowen disease (PBD) and primary extramammary Paget disease (EMPD) in selected cases. Although diffuse staining with cytokeratin 7 (CK7), CAM5.2, carcinoembryonic antigen, epithelial membrane antigen (EMA), and gross cystic disease fluid protein 15 generally supports diagnosis of EMPD, cases have been reported where PBD also expressed CK7, EMA, and CAM5.2. Based on these findings, some authors suggested that the 2 entities may arise from the same multipotent stem cell, capable of further differentiation toward squamous and secretory lines. To the best of our knowledge, this issue has never been investigated by comparing PBD and EMPD at the ultrastructural level. We performed the first ultrastructural study of a case of PBD exhibiting common immunohistochemical features with EMPD. The lesion displayed some ultrastructural features often observed in Bowen disease and some that are typically found in EMPD. These findings indicate the presence of a bidirectional differentiation--secretory and squamous--within the same lesion, thus supporting the hypothesis that PBD and primary EMPD may arise from a common progenitor cell.
*Department of Biomedical and Neuro Motor Sciences, Section of Anatomic Pathology "M.Malpighi" at Bellaria Hospital, University of Bologna, Bologna, Italy; †Department of Experimental Pathology, DIMES, University of Bologna, Bologna, Italy; ‡Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; and §Department of Dermatology, Bellaria Hospital, Bologna, Italy.
Chiara
C
Baldovini
Christine M
CM
Betts
Camilla
C
Reggiani
Maurizio
M
Reggiani
Maria P
MP
Foschini
D000368:Aged; D001913:Bowen's Disease / Q000737:chemistry* / Q000473:pathology / Q000648:ultrastructure*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002352:Carrier Proteins / Q000032:analysis; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007633:Keratins / Q000032:analysis*; D008297:Male; D058950:Melanoma-Specific Antigens / Q000032:analysis; D026901:Membrane Transport Proteins; D018396:Mucin-1 / Q000032:analysis; D010145:Paget Disease, Extramammary / Q000737:chemistry*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D012878:Skin Neoplasms / Q000737:chemistry* / Q000000981:diagnostic imaging* / Q000473:pathology; D014157:Transcription Factors / Q000032:analysis; D025521:Tumor Suppressor Proteins / Q000032:analysis; D014463:Ultrasonography; D058951:gp100 Melanoma Antigen
D002272:Carcinoembryonic Antigen; D002352:Carrier Proteins; D006023:Glycoproteins; D007633:Keratins; D058950:Melanoma-Specific Antigens; D026901:Membrane Transport Proteins; D018396:Mucin-1; D018719:Erb-b2 Receptor Tyrosine Kinases; D009418:S100 Proteins; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; D058951:gp100 Melanoma Antigen; C488892:PIP protein, human; C548637:PMEL protein, human; C115051:TP63 protein, human; C508053:ERBB2 protein, human