Document Detail

Ber-EP4 enhances the differential diagnostic accuracy of cytokeratin 7 in pagetoid cutaneous neoplasms.
MedLine Citation:
PMID:  18333896     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: While cytokeratin 7 is a reliable marker for most cases of Paget's disease, it is not 100% sensitive. Moreover, cases of cytokeratin 7-positive pagetoid squamous cell carcinoma in situ are reported in the literature. The monoclonal antibody Ber-EP4 is diagnostically highly reliable in the differentiation between basal cell carcinoma and cutaneous squamous cell carcinoma. Here we report its application in the differential diagnosis of cutaneous pagetoid neoplasms. METHODS: Biopsy samples from 21 cases of extramammary Paget's disease, 12 pagetoid squamous cell carcinomas in situ and 10 pagetoid melanomas in situ of the superficial spreading type were examined immunohistochemically with Ber-EP4, 34betaE12 and HMB-45. RESULTS: Ber-EP4 selectively labeled all cases of extramammary Paget's disease but none of the other pagetoid neoplasms. The majority of cases (18 = 85.7%) displayed strong and three (14.3%) showed moderate immunoreactivity. CONCLUSIONS: Ber-EP4 reliably differentiates extramammary Paget's disease from pagetoid squamous cell carcinoma in situ and pagetoid melanoma in situ. The antibody should be included along with a panel of other markers when evaluating for pagetoid cutaneous neoplasms in order to avoid a possible misdiagnosis of pagetoid squamous cell carcinoma in situ.
Klaus Sellheyer; Dieter Krahl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cutaneous pathology     Volume:  35     ISSN:  1600-0560     ISO Abbreviation:  J. Cutan. Pathol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-04-01     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0425124     Medline TA:  J Cutan Pathol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  366-72     Citation Subset:  IM    
Department of Dermatology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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MeSH Terms
Carcinoma in Situ / diagnosis*
Carcinoma, Squamous Cell / diagnosis*
Diagnosis, Differential
Keratin-7 / metabolism*
Melanoma / diagnosis*
Paget Disease Extramammary / diagnosis*
Reproducibility of Results
Skin Neoplasms / diagnosis*
Tumor Markers, Biological / metabolism*
Reg. No./Substance:
0/Keratin-7; 0/Tumor Markers, Biological; 0/human epithelial antigen-125

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