View Case

Back

Questions
Discussion
References

Show the short figure legend

Show the complete figure description

1214) A woman presents with an erythematous, ulcerated lesion of the nipple. The following photomicrograph shows staining of neoplastic cells. These cells MOST likely demonstrate which of the following immunophenotypes?

Cytokeratin 7 (CK7) positive, carcinoembryonic antigen (CEA) positive, HER-2/neu overexpressed, CAM5.2/B5BetaH11 positive CK5/6 positive, CK7 positive, CK20 positive, BerEp4 positive, B72.3 positive CEA positive, CK5/6 positive, CK7 negative, S100 negative, ER (estrogen receptor) positive, PR (progesterone receptor) positive CK7 positive, S100 positive, CK20 positive, EMA (epithelial membrane antigen) negative, HMB45 negative CK5/6 positive, S100 positive, CK20 positive, EMA negative, HMB45 negative

Show Diagnosis/Topic

• Paget disease of the nipple reflects the immunophenotype of the underlying breast cancer. It is most commonly positive for cytokeratin 7 (CK7), low-molecular-weight CK, and carcinoembryonic antigen (CEA), as well as EMA. It usually overexpresses HER-2/neu.

• The majority of cases are S100 negative, and many are positive for estrogen receptor (ER) and PR expression.

• Unlike extramammary Paget disease, which may be CK20 positive, Paget disease of the nipple is CK20 negative.

• Although CK7 is very sensitive for Paget disease of the nipple, Toker cells are also CK7 positive.

• CK5/6 would be negative in most cases of Paget disease or if positive would not distinguish between Paget disease and squamous cells.

Hitchcock A, Topham S, Bell J, et al: Routine diagnosis of mammary Paget’s disease. A modern approach. Am J Surg Pathol 1992;16:58-61.

Smith KJ, Tuur S, Corvette D, et al: Cytokeratin 7 staining in mammary and extramammary Paget’s disease. Mod Pathol 1997;10:1069-1074.

Back

Anatomic Pathology: Immunopathology

1214) A woman presents with an erythematous, ulcerated lesion of the nipple. The following photomicrograph shows staining of neoplastic cells. These cells MOST likely demonstrate which of the following immunophenotypes?

View Notes

Add a Note