Diagnostic Criteria in Intraepithelial Pagetoid Neoplasms: A Histopathologic Study and Evaluation of Select Features in Paget Disease, Bowen Disease, and Melanoma In Situ

Abstract

Our study demonstrated a practical histologic approach to differentiate between intraepidermal pagetoid neoplasms. Careful histologic study of the proposed criteria may reduce reliance on immunohistochemical stains.

Differentiating pagetoid Bowen disease from Paget disease on the nipple‐areola complex: Two unique, challenging cases

“…2 It shows pagetoid cells in the epidermis, with a large, pale cytoplasm, that lack the immunohistochemical characteristics of Paget disease. [4][5][6] It is crucial to perform a correct differential diagnosis between pagetoid Bowen disease and Paget disease, especially when it is located on the breast, because therapeutic approach and prognosis is very different for each of them. [1][2][3] Bowen disease is an intraepidermal carcinoma, which only rarely progresses to invasive squamous cell carcinoma, and which is not linked to an underlying breast F I G U R E 1 Clinical features.…”

Focal CK7 Positivity in Pagetoid Bowen's Disease: A Mimic of Extramammary Paget's Disease

“…About 5% of Bowen's disease cases show a pagetoid growth pattern with atypical keratinocytes arranged singly and in nests 1 . Pagetoid Bowen's disease is an intraepidermal pagetoid neoplasm that is histologically characterized by the pagetoid spreading of atypical cells with vacuolated, pale cytoplasm in epidermis 1 .…”

“…About 5% of Bowen's disease cases show a pagetoid growth pattern with atypical keratinocytes arranged singly and in nests 1 . Pagetoid Bowen's disease is an intraepidermal pagetoid neoplasm that is histologically characterized by the pagetoid spreading of atypical cells with vacuolated, pale cytoplasm in epidermis 1 . The most common diagnoses of intraepidermal pagetoid neoplasms are pagetoid Bowen's disease, extramammary Paget's disease (EMPD), and melanoma in situ 1 2 .…”

“…Pagetoid Bowen's disease is an intraepidermal pagetoid neoplasm that is histologically characterized by the pagetoid spreading of atypical cells with vacuolated, pale cytoplasm in epidermis 1 . The most common diagnoses of intraepidermal pagetoid neoplasms are pagetoid Bowen's disease, extramammary Paget's disease (EMPD), and melanoma in situ 1 2 . There were some previous reports for differentiating these diseases using histological characteristics, including types of corneum, presence of crushed basal keratinocytes, presence of atypical clear cells in epidermis, presence of large cells with pale cytoplasm, and level of pagetoid atypical cells within the epidermis, as visualized with routine hematoxylin and eosin-stained sections 1 .…”

“…The most common diagnoses of intraepidermal pagetoid neoplasms are pagetoid Bowen's disease, extramammary Paget's disease (EMPD), and melanoma in situ 1 2 . There were some previous reports for differentiating these diseases using histological characteristics, including types of corneum, presence of crushed basal keratinocytes, presence of atypical clear cells in epidermis, presence of large cells with pale cytoplasm, and level of pagetoid atypical cells within the epidermis, as visualized with routine hematoxylin and eosin-stained sections 1 . Although these criteria reduce reliance on immunohistochemical stainings, immunohistochemistry is required for clear distinction in some cases.…”