Cytologic investigations of vulvar Paget's disease with underlying invasive eccrine duct carcinoma

Abstract

Cytologic investigations of the case of vulvar Paget's disease with underlying invasive eccrine duct carcinoma were performed.
The patient, a 80 year-old woman, was admitted to our hospital because of vulva itch. Histological examination of the tumor revealed Paget's disease of the vulva with underlying sweat gland carcinoma.
Cytological studies of the case revealed the presence of large and small atypical cells. The former showed scattered distribution, and the cytoplasms were abundant and stained pale. Cytoplasmic rims were distinct. Perinuclear halos were frequently noted. The nuclei were round and located centrally. The nuclear rims were thin and smooth. The chromatin patterns were finely granular. The nuclei were single, distinct and enlarged.
The latter were arranged in a sheet-like formation, but occasionally palisade patterns were found. Cytoplasmic rims were not distinct. The cytoplasms were stained pale and had a lace-like structure. Nuclei located eccentrically were round or oval with somewhat thick and irregular borders. The chromatin patterns were coarsely granular, and a few nucleoli were visible. The ultrastructural aspect suggested that the tumor cells might derive from the eccrine sweat glands because of the presence of dense granules and the formation of intracellular canaliculi in which microvilli were observed.