2018 Volume 57 Issue 2 Pages 136-141
Background : Vulvar Paget’s disease is a rare malignancy of the vulva. Herein, we describe the cytological features of two cases of vulvar Paget’s disease in which the diagnosis was suspected from the findings of scraping cytology.
Case : Case 1 : An 82-year-old woman presented with a 2-year history of pruritus and redness of the vulva. Vulvar cytology revealed some small isolated cells with fine nuclear chromatin and a high N/C ratio. The cellular nuclei contained multiple nucleoli and many cells with mild nuclear irregularities were also observed. Furthermore, a cell with a mutual inclusion was also seen.
Case 2 : A 79-year-old woman was referred to us with a uterine myoma. Physical examination revealed extensive eczema-like erythema of the vulvar area. Vulvar scraping cytology revealed some small isolated cells with micro chromatin in the nuclei and a high N/C ratio. A small planar clump was also seen, composed of cells with a high N/C ratio, with the nuclei containing prominent nucleoli, and fine chromatin.
Conclusion : In cases with vulvar lesions where scraping cytology reveals glandular cells with atypical morphology, it is necessary to conduct detailed examination bearing in mind the possible diagnosis of Paget’s disease. For effective vulvar scraping cytology, namely, to maximize the number of cells collected, use of a brush may be useful.
