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Case of the Month

 



CASE OF THE MONTH

Paget Disease



The patient is a 53-year-old woman who presents to her clinician with vulvar itching. She has red and white scaly patches, similar in appearance to eczema. A random biopsy is obtained. The biopsy shows single and small clusters of large cells with pale, vacuolated cytoplasm just above the basal layer of epidermis. There are cleft-like spaces between the Paget’s cells and the neighboring keratinocytes. There are no intercellular bridges within the clusters of malignant cells and no evidence of keratinization. Immunoperoxidase stains show that the malignant cells are positive for CK7 and polyclonal CEA and negative for S100 protein. The diagnosis is Paget’s disease.



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