Limits...
Polarized dermoscopy of mammary Paget disease.

Crignis GS, Abreu Ld, Buçard AM, Barcaui CB - An Bras Dermatol (2013 Mar-Apr)

Bottom Line: Mammary Paget's disease is a rare intraepithelial adenocarcinoma, located on the nipple/areola complex, highly associated with breast cancer.Although the international literature emphasizes the dermatoscopic pattern of mammary Paget's disease pigmented variant, the authors describe the dermoscopic findings of classical Paget's disease and demonstrate the presence of chrysalis-like structures, criteria recently described in the literature and not yet reported in Paget's disease.

View Article: PubMed Central - PubMed

Affiliation: Federal Hospital Bonsucesso, Bonsucesso, (RJ), Brazil. decrignisgiselly@yahoo.com.br

ABSTRACT
Mammary Paget's disease is a rare intraepithelial adenocarcinoma, located on the nipple/areola complex, highly associated with breast cancer. Although the international literature emphasizes the dermatoscopic pattern of mammary Paget's disease pigmented variant, the authors describe the dermoscopic findings of classical Paget's disease and demonstrate the presence of chrysalis-like structures, criteria recently described in the literature and not yet reported in Paget's disease.

Show MeSH

Related in: MedlinePlus

A. Clinical appearance of lesion with radical mastectomy scar on the right andchange in morphology and pigmentation of the left nipple and areola; B. In moredetail, lesion shows erythematous plaque on the left areolar region, with pinkish-brown color associated with centrifugal growth and retraction of the left nipple;C. Histopathological sections of mammary Paget's disease: aggregates of atypicalcells in the epidermis, with large hyperchromatic nuclei and abundant cytoplasm(HE-200x); D. Melanin granules in the cytoplasm of tumor cells (PAS- 200X)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3750901&req=5

f01: A. Clinical appearance of lesion with radical mastectomy scar on the right andchange in morphology and pigmentation of the left nipple and areola; B. In moredetail, lesion shows erythematous plaque on the left areolar region, with pinkish-brown color associated with centrifugal growth and retraction of the left nipple;C. Histopathological sections of mammary Paget's disease: aggregates of atypicalcells in the epidermis, with large hyperchromatic nuclei and abundant cytoplasm(HE-200x); D. Melanin granules in the cytoplasm of tumor cells (PAS- 200X)

Mentions: A 77- year- old woman was referred to our department by a gynecologist, regarding a 5-year history of progressively enlarged erythematous plaque in her left breast, withoccasional burning. She underwent a radical mastectomy and lymph node dissection of theright breast due to adenocarcinoma diagnosed 15 years before the onset of this skinlesion (Figure 1). Clinical appearance of thelesion shows an eczematous-like plaque with a thin, asymmetric and scaly surface,brownish-pink pigmentation in the left areola and nipple with centrifugal growthassociated with nipple retraction (Figure 1).General physical examination revealed no abnormalities. There were no palpable masses inthe breast or axillary lymphadenopathy. Dermoscopic examination of the central portionof the lesion showed a whitish-pink area with irregular linear vessels andchrysalis-like structures (Figure 2), whereas thedarker portion was characterized by dark brown diffuse pigmentation with irregularblue-gray dots (Figure 2). The clinical anddermoscopic features, although not specific, suggested mammary Paget's disease oramelanotic melanoma. Incisional biopsy was performed. Histopathological sections stainedwith hematoxylineosin showed large atypical cells with hyperchromatic eccentric nucleiand abundant cytoplasm throughout all levels of the epidermis (Figure 1). The tumor cells contained melanin granules within thecytoplasm and were positive for periodic acid-Schiff (PAS) staining - compatible withPaget's disease of breast (Figure 1). The patientwas referred to surgical excision and radical mastectomy and hormonal blockade wascarried out.


Polarized dermoscopy of mammary Paget disease.

Crignis GS, Abreu Ld, Buçard AM, Barcaui CB - An Bras Dermatol (2013 Mar-Apr)

A. Clinical appearance of lesion with radical mastectomy scar on the right andchange in morphology and pigmentation of the left nipple and areola; B. In moredetail, lesion shows erythematous plaque on the left areolar region, with pinkish-brown color associated with centrifugal growth and retraction of the left nipple;C. Histopathological sections of mammary Paget's disease: aggregates of atypicalcells in the epidermis, with large hyperchromatic nuclei and abundant cytoplasm(HE-200x); D. Melanin granules in the cytoplasm of tumor cells (PAS- 200X)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750901&req=5

f01: A. Clinical appearance of lesion with radical mastectomy scar on the right andchange in morphology and pigmentation of the left nipple and areola; B. In moredetail, lesion shows erythematous plaque on the left areolar region, with pinkish-brown color associated with centrifugal growth and retraction of the left nipple;C. Histopathological sections of mammary Paget's disease: aggregates of atypicalcells in the epidermis, with large hyperchromatic nuclei and abundant cytoplasm(HE-200x); D. Melanin granules in the cytoplasm of tumor cells (PAS- 200X)
Mentions: A 77- year- old woman was referred to our department by a gynecologist, regarding a 5-year history of progressively enlarged erythematous plaque in her left breast, withoccasional burning. She underwent a radical mastectomy and lymph node dissection of theright breast due to adenocarcinoma diagnosed 15 years before the onset of this skinlesion (Figure 1). Clinical appearance of thelesion shows an eczematous-like plaque with a thin, asymmetric and scaly surface,brownish-pink pigmentation in the left areola and nipple with centrifugal growthassociated with nipple retraction (Figure 1).General physical examination revealed no abnormalities. There were no palpable masses inthe breast or axillary lymphadenopathy. Dermoscopic examination of the central portionof the lesion showed a whitish-pink area with irregular linear vessels andchrysalis-like structures (Figure 2), whereas thedarker portion was characterized by dark brown diffuse pigmentation with irregularblue-gray dots (Figure 2). The clinical anddermoscopic features, although not specific, suggested mammary Paget's disease oramelanotic melanoma. Incisional biopsy was performed. Histopathological sections stainedwith hematoxylineosin showed large atypical cells with hyperchromatic eccentric nucleiand abundant cytoplasm throughout all levels of the epidermis (Figure 1). The tumor cells contained melanin granules within thecytoplasm and were positive for periodic acid-Schiff (PAS) staining - compatible withPaget's disease of breast (Figure 1). The patientwas referred to surgical excision and radical mastectomy and hormonal blockade wascarried out.

Bottom Line: Mammary Paget's disease is a rare intraepithelial adenocarcinoma, located on the nipple/areola complex, highly associated with breast cancer.Although the international literature emphasizes the dermatoscopic pattern of mammary Paget's disease pigmented variant, the authors describe the dermoscopic findings of classical Paget's disease and demonstrate the presence of chrysalis-like structures, criteria recently described in the literature and not yet reported in Paget's disease.

View Article: PubMed Central - PubMed

Affiliation: Federal Hospital Bonsucesso, Bonsucesso, (RJ), Brazil. decrignisgiselly@yahoo.com.br

ABSTRACT
Mammary Paget's disease is a rare intraepithelial adenocarcinoma, located on the nipple/areola complex, highly associated with breast cancer. Although the international literature emphasizes the dermatoscopic pattern of mammary Paget's disease pigmented variant, the authors describe the dermoscopic findings of classical Paget's disease and demonstrate the presence of chrysalis-like structures, criteria recently described in the literature and not yet reported in Paget's disease.

Show MeSH
Related in: MedlinePlus