• Archives of Plastic Surgery
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• v.47 no.1
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• pp.83-87
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• 2020

Extramammary Paget disease (EMPD) is an uncommon malignancy that occurs in apocrine gland-rich areas of the body. EMPD of the axilla is rare, but a few cases have been reported. Some cases of EMPD have been reported with underlying apocrine adenocarcinoma; rarely, mammary-type ductal carcinoma can accompany EMPD. Here, we report a very rare case of EMPD with apocrine adenocarcinoma and invasive mammary-type ductal carcinoma. A 55-year-old woman was referred with a brownish pigmented plaque accompanying an area of ulceration in the left axilla. A preoperative biopsy indicated Paget disease, and an additional evaluation was performed to determine whether it was of primary or secondary origin. A wide excision was made, and the axilla was reconstructed using a thoracodorsal artery perforator flap. The biopsy showed apocrine adenocarcinoma and invasive mammary-type ductal carcinoma with pagetoid spreading. The patient had no evidence of recurrence or other postoperative complications.

• The Korean Journal of Cytopathology
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• v.14 no.2
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• pp.76-81
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• 2003

Apocrine carcinoma of the breast is a very rare subtype. Although it has no clinical differences from usual ductal carcinoma of the breast, it should be categorized as a subtype of breast carcinoma because the cells of apocrine carcinoma reveal characteristic abundant eosinophillic cytoplasms with intraductal apical snouting as well as round or oval nuclei and central macronucleoli. On fine needle aspiration cytology, the cells of apocrine carcinoma have a lot of similarity to benign or reactive apocrine cells of the breast. Therefore, it is difficult to make a differential diagnosis of apocrine carcinoma from mammary neoplasms with similar cytologic findings unless the subtle cytologic differences are recognized. We report the cytologic and histologic findings of a case of apocrine carcinoma in the breast of a 40-year-old female patient. After the fine needle aspiration cytology, she received the lumpectomy and lymph node dissection. The cellularity was moderate to high. The cytoplasmic borders of tumor cells of three-dimensional clusters were relatively distinctive, and the cytoplasm was abundant, eosinophilic, and granular. Although the nuclear/cytoplasmic ratio was low, the nuclei of the cells were variable in size and shape with prominent macronucleoli. Histologically, it was a typical invasive apocrine carcinoma, showing numerous cytoplasmic lysosomes and mitochondriae on electron microscopy.

• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.27-34
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• 1999

Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carcinomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. Ail cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papillomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(57%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases on papillary lesions of the breast to further characterize the tumor.