Immunohistochemical study of mammary and extra‐mammary Paget's disease

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Abstract
Paraffin sections of 13 cases of Paget''s disease (6 mammary and 7 extramammary) were investigated with mono- and polyclonal anti-carcinoembryonic antigen (CEA) and with monoclonal anti-human milk fat globule membrane antigen (HMFG). One of these cases was also analyzed in cryostat sections with monoclonal anti-cytokeratin and anti-keratin. Three immunohistological labeling patterns were identified. All 6 cases of mammary Paget''s disease were positive for anti-HMFG and negative with monoclonal anti-CEA (although they stained to a variable degree with polyclonal anti-CEA); 2 cases of extra-mammary Paget''s disease (both anal location) were positive with monoclonal anti-CEA and only weakly stained for HMFG, suggesting epidermal spread from colo-rectal carcinoma; the other 5 cases of extramammary Paget''s disease were negative or weakly stained for CEA and positive for HMFG. This group of cases apparently represents epidermotropic eccrine carcinoma. The immunohistochemical use of monoclonal anti-HMFG and -CEA is helpful in the diagnosis of Paget''s disease; it gives information about the origin of the primary tumor.