Pagetoid dyskeratosis of the cervix: an incidental histologic finding in uterine prolapse.
ABSTRACT Pagetoid dyskeratosis, is considered a reactive process in which a small part of the normal population of keratinocytes is induced to proliferate. The lesion is characterized by pale cells resembling those of Paget's disease within the epidermis. These cells have been seen as an incidental finding in a variety of benign papules most commonly located in intertriginous areas. Among the inductors of the lesion, friction is suspected. To the best of our knowledge, these pale cells have not been reported in the cervix. We describe the location of the lesion in the ectocervix and the incidence of this lesion in a group of 100 unselected patients surgically treated for uterine prolapse. Another group of 100 unselected patients treated for uterine leiomyoma was used as a control. Pagetoid dyskeratosis was found in 37 cases (37%) of uterine prolapse and in five cases (5%) of uterine leiomyomas. The lesion is more common in uterine prolapse (p <0.001) and is not significantly associated with cornification of the epithelium (p = 0.72343). The cells of pagetoid dyskeratosis show an immunohistochemical profile different from the surrounding squamous cells characterized by premature keratinization. Pagetoid dyskeratosis cells have shown positivity for high molecular weight cytokeratin and negative reaction for low molecular weight cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and human papilloma virus. Pagetoid dyskeratosis cells must be distinguished from artefactual clear cells, glycogen-rich cells, koilocytes, extramammary Paget's disease cells, and pagetoid spread of carcinoma cells to the cervix. In cases in which pagetoid dyskeratosis shows a florid expression, there is a hazard of overdiagnosis. The pathologist should be aware of the histologic features of pagetoid dyskeratosis in the ectocervix to avoid misdiagnosis and unnecessary treatment. Routine histologic study is usually sufficient to identify the lesion.
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ABSTRACT: : Pagetoid dyskeratosis refers to a characteristic pathologic aspect of keratinocytes of the epidermis and other stratified epithelia, that have a size larger than normal, a pale cytoplasm and a pycnotic nucleus surrounded by a clear halo. This aspect has been reported, often as an incidental finding, in benign conditions. We observed a case of Bowen disease featuring pagetoid dyskeratosis remarkable because the cells concerned were in mitosis, a finding so far unreported. We call this aspect "proliferating pagetoid dyskeratosis" to differentiate it from the usual pagetoid dyskeratosis and to highlight its association with mitotic nuclei. The significance of this rare finding warrants further study.The American Journal of dermatopathology 05/2014; 36(5):e97-e99. DOI:10.1097/DAD.0000000000000002 · 1.30 Impact Factor
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ABSTRACT: Pagetoid dyskeratosis is an incidental histological finding observed in biopsies from various skin and mucosal lesions and has been described in various anatomic locations. It is characterised by appearance of pale cells resembling those seen in Paget’s disease. We report a 35-year-old male who presented with progressive forehead hyperpigmentation that on histologic examination showed features of pagetoid dyskeratosis. To our knowledge this may represent the first case report describing this entity on the forehead12/2013; DOI:10.4103/2229-5178.131128
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ABSTRACT: Long considered to be ectopic breast tissue representing the caudal remnants of the milk ridges, anogenital mammary-like glands are nowadays thought to represent a normal constituent of the anogenital area. Lesions involving these glands, benign or malignant, epithelial or stromal manifest a striking similarity to their mammary counterparts. This review addresses the recent literature on lesions of anogenital mammary-like glands and our personal experience with various lesions related to these structures. Discussed are the normal anatomy and histology of these glands as well as the clinical presentation, histopathological and immunohistochemical features, molecular biological aspects, and differential diagnosis of various lesions involving anogenital mammary-like glands, including lactating adenoma, hidradenoma papilliferum, hidradenocarcinoma papilliferum, fibroadenomas, phyllodes tumor, pseudoangiomatous stromal hyperplasia, extramammary Paget disease, and other carcinomas. In addition, "nonspecific" epithelial or stromal changes some of which can be likened to similar changes occurring in a range of benign breast disease, including sclerosing adenosis, columnar cell lesions, ductal lesions and various metaplastic changes affecting epithelium and myoepithelium are discussed. Although lesions of anogenital mammary-like glands are often discussed in many dermatopathology textbooks in the context of cutaneous adnexal neoplasms we advocate that the best approach to the diagnosis of these lesions is to relate them to analogous well recognized lesions occurring in the breast, that is, through the eyes of a breast pathologist. This will enable their recognition, precise classification and should introduce greater uniformity in how they are reported in the literature so that more meaningful clinicopathological comparisons and correlations may be made.Advances in anatomic pathology 01/2011; 18(1):1-28. DOI:10.1097/PAP.0b013e318202eba5 · 3.22 Impact Factor