70岁妇女外阴病变。

学习！

 又是精彩的一课，Paget's 的诊断和鉴别讲解的清晰明了！

Thanks Dr.zhao！

 典型Paget 病病例.

论述丰富.

 "I wish our young pathologists to learn from this case not nly the dx of Paget's. The more importance is to learn the way or thought, priniciple  how to make your dx in clinical practice."

Thanks Pro cz fou your kindness and encouragement. We  all have learned so much from your speech and discussion.Thank you,sir!

 Above summary is from one of our first year pathology resident. In fact she is resident only for the two month (starting from July, 2009).Residents and fellows need to prepare a lot of talks, case discussion, paper review in department conference, tumor board. They learn pathology knowledge when they prepare the talk. In fact I learned some new information from above our resident's presentaion. Also pathologists need to give reisdents and fellow many teaching course.   

Some of the number or percentage may be not very accurate depending the papers you read. You can get a general information about EMPD.

I wish our young pathologists to learn from this case not nly the dx of Paget's. The more importance is to learn the way or thought, priniciple  how to make your dx in clinical practice.

As pathologists we always should have differential dx for our cases even for some easy cases. For all paget's dieases we always order some stains to support our dx even though we almost are sure the dx based on the H@E slides. We do not want to misdiagosed melanoma or paget's. This is called low level but too significant mistakes. We may lost the job if we make this kind of mistakes.

Ok, I will finish this topic. Thank all of you who read or wrote the discussion for this topic. I especially appreciate 青青子矜 and Dr. Zhang for sharing their study or review summary.

It is the morning in China and in the US we are in the Friday night. I am playing 麻将game with my family tonight. I just learn it recently. I feel it is interesting and a good relaxing game.

Good weekend, cz

IHC for histologic differential diagnosis

n      Pagetoid Bowen’s Disease: CAM 5.2, CEA, EMA + in PD

n      Melanoma: S-100 may be + in PD, but HMB-45 is –

n      Mycosis Fungoides: CD3 +

n      Toker cells: CEA –

Conclusion

n      Extramammary Paget’s Disease is an uncommon neoplasm, occurring most frequently in postmenopausal women on the vulva

n      It was once believed to be secondary to underlying neoplasms, like mammary PD.

n      Currently it is thought to be divided into two separate types, primary and secondary.

n      IHC can aid in determining the type of EMPD and the origin of secondary EMPD.

n      Toker cells may be the precursor cells in primary EMPD. 

Comparison of IHC Results