Abstract
A 64-year-old female patient had a complaint of a finger tip size erythematous focus gradually growing in the left inguinal region.The patient has recently noticed this erythematous focus of the 3-year duration enlarging rapidly, reaching the left labium majus.
The microscopic findings of the scrape smear of the focus was such that a few malignant cells were scatte red among many ghost cells.The eccentric nuclei of the malignant cells had developed anisonucleosis and the size of the nuclei were12-18μAin diameter. The chromatin pattern was uniformly coarsely granular with irregular concentration of chromatin around the nuclear membrane. The nucleole was centric and showed a tendency to macronucleole. The cytoplasm was rather abundunt and was usually vacuolated. Its cytoplasmic margin was clearly defined. Periodic acid Schiff staining revealed the presence of fine PAS positive granules around the cytoplasmic margin.By alcian blue double staining method, the cells showed a weak positive reaction; i. e. the evidence of adenomatous malignant cells. In addition, pathological tissue examination showed a strong PAS positive reaction (diastase digestion was used), and from the morphologic aspects of the cells, the patient was diagnosed as having extramammary Paget's disease.
As the so called P-cells assume a character of adenoma tous malignant cells in cytology, the detection of these cells in a scrape smear test of the vulvar requires the consideration of Paget's disease.
