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首页> 外文期刊>Diagnostic cytopathology >Extramammary paget's disease mimicking localized malignancy on cervical cytology
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Extramammary paget's disease mimicking localized malignancy on cervical cytology

机译：子宫颈佩吉特病模仿宫颈细胞学上的局部恶性肿瘤

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A case of Extramammary Paget's Disease (EMPD) involving the cervix mimicking cervical carcinoma on routine cervical cytology in a 66-year-old woman with a history of recurrent multifocal EMPD involving the vulva, perineum, perianal area, and rectum is reported. The patient had undergone multiple excisions and reconstructions of EMPD, however, had a benign cervical smear history and reported no vaginal bleeding. The conventional papanicolaou smear was reported as concerning for carcinoma with abundant, well preserved material illustrating highly atypical cells with anisonucleosis and dense cytoplasm and focal microacini. Gross anatomical distortion from EMPD and previous surgery precluded satisfactory outpatient colposcopic assessment. Examination under anesthesia was performed and colposcopy revealed a four quadrant high grade lesion extending into the vagina with one area suspicious for malignancy on the cervix. Directed biopsies were taken and histopathology confirmed EMPD with diffuse adenocarcinoma in situ cells infiltrating skin and mucosa of all specimens. These large pale cells were seen both a singly and in clusters of nests within the mucosa. Periodic Acid Schiff staining was positive for intracytoplasmic mucin and supportive immunohistochemistry was performed with strong reactivity in atypical cells for CK7, CEA, and Cam 5.2. There was no evidence of invasive malignancy and the patient remains under clinical surveillance. Cervical EMPD is rare but should be considered in women with abnormal cervical cytology and a history of vulval EMPD. Diagn. Cytopathol. 2016;44:931-934. (c) 2016 Wiley Periodicals, Inc.
机译：据报道，一名66岁的女性患有常规子宫颈细胞学检查，其子宫颈模仿宫颈癌的子宫颈佩吉特病（EMPD）病史，该病史反复涉及多发性EMPD，涉及外阴，会阴，肛周区和直肠。该患者经历了多次切除和EMPD重建，但是有良性宫颈涂片病史，没有阴道流血的报道。据报道，常规的木瓜涂片检查与癌有关，其材料丰富，保存完好，说明高度非典型的细胞具有异核细胞增多症，致密的细胞质和局灶性微腺泡。 EMPD和先前的手术造成的大体解剖畸变使门诊患者的阴道镜评估无法令人满意。在麻醉下进行检查，并在阴道镜检查下发现四象限高级别病变延伸到阴道，其中一个区域可怀疑子宫颈的恶性肿瘤。进行定向活检，并且组织病理学证实EMPD伴有浸润所有样本的皮肤和粘膜的弥漫性腺癌原位细胞。这些巨大的苍白细胞既可见，也可见于粘膜内的巢簇。高碘酸希夫（Schiff）染色对胞浆内粘蛋白呈阳性，并且在非典型细胞中对CK7，CEA和Cam 5.2进行了支持性免疫组化，反应性强。没有浸润性恶性肿瘤的证据，患者仍处于临床监测之下。宫颈EMPD很少见，但宫颈细胞学异常且有外阴EMPD病史的女性应考虑使用。诊断细胞病。 2016; 44：931-934。 （c）2016年威利期刊有限公司

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