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Penile Analogue of Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: The First Described Case. A Diagnostic Pitfall
M. Michal, M. Michal, M. Miesbauerova, J. Hercogova, B. Skopalikova, DV. Kazakov,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu kazuistiky, časopisecké články, práce podpořená grantem
- MeSH
- biopsie MeSH
- chybná diagnóza MeSH
- dysplazie děložního hrdla chemie patologie MeSH
- extramamární Pagetova nemoc patologie MeSH
- imunohistochemie MeSH
- inhibitor p16 cyklin-dependentní kinasy analýza MeSH
- invazivní růst nádoru MeSH
- karcinom in situ chemie patologie virologie MeSH
- karcinom chemie patologie virologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lidský papilomavirus 16 izolace a purifikace MeSH
- metaplazie MeSH
- nádorové biomarkery analýza MeSH
- nádory cystické, mucinózní a serózní chemie patologie virologie MeSH
- nádory děložního čípku chemie patologie MeSH
- nádory penisu chemie patologie virologie MeSH
- pohárkové buňky chemie patologie virologie MeSH
- prediktivní hodnota testů MeSH
- progrese nemoci MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
The authors report a case where undifferentiated (classic) penile intraepithelial neoplasia was associated with the presence of goblet cells throughout the full epithelial thickness and which later progressed into an invasive carcinoma. The lesion evolved in three consecutive biopsies from only surface epithelium occupying numerous goblet cells in the first to variably sized solid nodules in the dermis composed of atypical squamous and/or basaloid cells intermixed with numerous goblet cells in the third biopsy. Both cellular components expressed CK7 and p16 protein. Human Papillomavirus (HPV) genotyping revealed high risk HPV type 16. To the best of our knowledge, this is the first description of such a lesion occurring on the penis, which can be considered the penile analogue of cervical stratified mucin-producing intraepithelial lesion (SMILE). The correct diagnosis was rendered retrospectively, after recognition of the existence of a vulvar lesion resembling cervical SMILE. The initial biopsy was misinterpreted as extramammary Paget disease, which also constitutes the main pitfall in the differential diagnosis. Another important differential diagnosis is penile/vulvar mucinous metaplasia. The finding of atypical squamous epithelial cells positive for p16 associated with mucinous cells present throughout the full epithelial thickness is a clue to the diagnosis of penile SMILE.
Citace poskytuje Crossref.org
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- $a Michal, Michael $u *Department of Pathology, Charles University, Biomedical Center, Faculty of Medicine in Plzen and Charles University Hospital Plzen, Pilsen, Czech Republic; †Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Pilsen, Czech Republic; ‡Department of Dermatovenereology, Charles University, 2nd Faculty of Medicine and Bulovka Hospital, Prague, Czech Republic; and §Department of Pathology, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic.
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- $a The authors report a case where undifferentiated (classic) penile intraepithelial neoplasia was associated with the presence of goblet cells throughout the full epithelial thickness and which later progressed into an invasive carcinoma. The lesion evolved in three consecutive biopsies from only surface epithelium occupying numerous goblet cells in the first to variably sized solid nodules in the dermis composed of atypical squamous and/or basaloid cells intermixed with numerous goblet cells in the third biopsy. Both cellular components expressed CK7 and p16 protein. Human Papillomavirus (HPV) genotyping revealed high risk HPV type 16. To the best of our knowledge, this is the first description of such a lesion occurring on the penis, which can be considered the penile analogue of cervical stratified mucin-producing intraepithelial lesion (SMILE). The correct diagnosis was rendered retrospectively, after recognition of the existence of a vulvar lesion resembling cervical SMILE. The initial biopsy was misinterpreted as extramammary Paget disease, which also constitutes the main pitfall in the differential diagnosis. Another important differential diagnosis is penile/vulvar mucinous metaplasia. The finding of atypical squamous epithelial cells positive for p16 associated with mucinous cells present throughout the full epithelial thickness is a clue to the diagnosis of penile SMILE.
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