Document Detail

Pagetoid squamous cell carcinoma in situ of the vulva: comparison with extramammary paget disease and nonpagetoid squamous cell neoplasia.
MedLine Citation:
PMID:  18156986     Owner:  NLM     Status:  MEDLINE    
Pagetoid squamous cell carcinoma in situ (PSSCIS) is a variant of squamous cell intraepithelial neoplasia. Although PSSCIS is well-documented in the cutaneous skin and esophagus, cases of vulvar PSSCIS are rare. In the vulva, the main differential diagnosis is extramammary Paget disease (EMPD). We report 2 cases of vulvar PSSCIS along with the immunohistochemical and human papillomavirus (HPV) status of this disease compared with primary cutaneous EMPD of the vulva. Although PSSCIS and EMPD share CK7 and CK19 expression, PSSCIS is consistently mucin and carcinoembryonic antigen negative. In contrast to EMPD, both cases of PSSCIS strongly expressed p16 (INK4A) protein, consistent with RB1 protein dysregulation. However, integration of high-risk HPV was found in only 1 of the 2 PSSCIS cases. Given the morphological and immunohistochemical findings, we suggest that PSSCIS arises from a bidirectional stem cell capable of both squamous and glandular differentiation. Additionally, as with nonpagetoid squamous cell neoplasias of the vulvar, integration of high-risk HPV may occur in some, but not all, cases of PSSCIS.
Jane E Armes; Rohan Lourie; Greg Bowlay; Sepehr Tabrizi
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists     Volume:  27     ISSN:  0277-1691     ISO Abbreviation:  Int. J. Gynecol. Pathol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-02-20     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8214845     Medline TA:  Int J Gynecol Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  118-24     Citation Subset:  IM    
Department of Anatomical Pathology, Mater Health Services, South Brisbane, Queensland, Australia.
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MeSH Terms
Carcinoma in Situ / metabolism,  pathology*,  virology
Carcinoma, Squamous Cell / metabolism,  pathology*,  virology
In Situ Hybridization
Paget Disease Extramammary / metabolism,  pathology*,  virology
Papillomavirus Infections / complications
Polymerase Chain Reaction
Receptor, erbB-2 / genetics
Tumor Markers, Biological / analysis
Vulvar Neoplasms / metabolism,  pathology*,  virology
Reg. No./Substance:
0/Tumor Markers, Biological; EC, erbB-2

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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