简介:Paget'sdiseaseofboneisafocaldisorderofboneremodellingcausedbyabnormallyincreasedosteoclast-mediatedboneresorption.qtleaffectedboneschangeinshaw,sizeanddirection,whiletherestoftheskeletonremainsnormal.TheclinicalconsequencesofthediseasewerefirstdescribedbySirJanlesPagetin1876(Figure1).
简介:摘要目的探讨乳头Paget’s病的临床特点、诊断及治疗方法,提高对乳头Paget’s病的诊治水平。方法回顾性分析我院2011年8月至2014年8月间收治的12例乳头Paget’s病患者的临床资料结果单纯湿疹样改变者2例,单纯乳腺肿块者3例,乳头湿疹样改变伴乳腺肿块者7例。最终病理证实乳腺浸润性导管癌伴乳头Paget’s病者8例,占所有病例的66.7%;导管内癌伴乳头Paget’s病者3例,占所有病例的25%;导管内癌局部微浸润伴乳头Paget’s病者1例,占所有病例的8.3%。结论乳头paget’s多伴有乳腺深部肿块,伴肿块的乳头paget’s病出现浸润性乳腺癌的可能性较大。预后较单纯浸润性乳腺癌差,需更为积极的综合治疗。
简介:<正>乳腺外Paget病是一种罕见的疾病,现本院收治1例,报告如下。1病例简介患者男,68岁,以"阴囊湿疹,局部皮肤苔藓样变10余年"来诊。人院查体见阴囊潮湿,阴囊根部近肛门处皮肤可见大小约3cm×5cm白色苔藓样变(见图1),局部红肿,轻度糜烂,伴炎性渗出物,边界不清,自述瘙痒、疼痛。双侧腹股沟可触及多个淋巴结,约1cm×0.8cm大小,余未见明显异常。B超提示双侧腹股沟可见多个肿大淋巴结,建议结合临床。患者在外院行阴囊区皮肤活检,病理提示表皮显著增生,表皮脚增宽延长,棘细胞大小不等,排列紊乱,核深染,并见较多Paget细胞
简介:AbstractIntroduction:Erosive adenomatosis of the nipple is a rare benign lesion involving nipple which can be easily misdiagnosed as more ominous entities such as Pagets disease.Here we reported a case of erosive adenomatosis on the nipple masquerading as paget’s disease.Case presentation:A 21-year-old woman presented with a 6-year history of breast erythema involving her left nipple with tenderness and mild itching. The nipple appeared rough and thickened with areas of erosion and fissuring. Physical examination of other areas of breast as well as imaging studies including ultrasound and mammography showed no abnormalities. The histological examination reveal adiagnosis of erosive adenomatosis of nipple (EAN). The patient was treated by a simple surgical excision without complications and recurrence during 9-month follow-up.Discussion:In the early stage, it can mimic eczema, but in the later stage, more serious diagnosis such as Pagets disease should be differential. It is diagnosed by histopathological examination. Surgical excision is an optimal choice for treament with or without plastic reconstruction.Conclusion:EAN should be considered in the diagnosis of erythema and erosion lesions involving nipple. The gold standard for diagnosis is histopathological examination. A prompt and correct diagnosis of EAN can avoid both unnecessary over treatment and patients emotional stress.
简介:摘要目的探讨乳腺外Paget病(extramammaryPagetdisease,EMPD)的临床病理特点及影响其预后的因素。方法回顾性分析20例EMPD的临床病理资料,复习存档HE切片,采用Envision两步法对20例EMPD进行免疫组化染色,随访患者生存状况,分析临床病理参数与预后的关系,并进行统计学分析。结果20例EMPD中男性16例,女性4例,发病年龄48—85岁,中位年龄60岁。肉眼观皮损呈湿疹样改变,镜检表皮内见数目不等的Paget细胞呈单个散在、巢状或腺样分布。免疫表型20例均表达CK7,不表达CK5/6,P63。18例获得随访资料,其中复发6例,4例复发后死亡,复发6例中4例切缘阳性。统计学分析显示,有真皮浸润组和无真皮浸润组(P<0.01和P<0.05),有淋巴结转移组和无淋巴结转移组(P<0.01),切缘阳性组和切缘阴性组(P<0.01和P<0.05)的复发率和病死率的比较差异均有统计学意义,患者年龄、病变范围与预后无显著相关性(P>0.05)。结论CK7是Paget细胞较敏感和特异的免疫标志物,肿瘤伴表皮下浸润、淋巴结转移、切缘阳性是患者预后不良的指标。
简介:摘要类风湿性关节炎是一种以关节病变引起肢体严重畸形,关节滑膜炎及浆膜、心肺、皮肤、眼、血管等结缔组织广泛性炎症为主要表现的慢性全身性自身免疫性疾病。滑膜炎持久反复发作,可导致关节内软骨和骨的破坏,关节功能障碍,甚至残废。目前医学界对本病的认识有多种不同的解释,但其具体病因病理尚不明确,故风湿病的诊疗效果不太乐观,给不计其数的患者带来了不少的痛苦,让广大医务工作者为之头疼。藏医药学已有二千多年的历史,形成了具有本民族特色,理论完整的医药体系,为人类的繁衍生息作出过重大贡献,是我国医药学宝库中不可分割的重要部分。