IMMUNOHISTOCHEMICAL FEATURES OF PAGETS-DISEASE OF THE VULVA WITH AND WITHOUT ADENOCARCINOMA

Six cases of vulvar Paget's disease (VP) with associated adenocarcinoma and 10 cases of VP without adenocarcinoma were compared immunohistochemically with B72.3, a pancarcinoma marker developed against human mammary tumor cells, anticarcinoembryonic antigen (anti-CEA), antiepithelial membrane antigen (anti-EMA), anti-gross cystic disease fluid protein (anti-GCDFP-15), antihuman estrogen receptors (anti-ER), and anti-S-100 protein (anti-S-100). B72.3 reacted with 15/16 (94%) of the cases, anti-CEA reacted with 15/16 (94%), anti-EMA reacted with 16/16 (100%), anti-GCDFP-15 reacted with 14/16 (81%), and none of the 16 cases reacted with anti-ER or anti-S-100. There was no statistically significant difference in the percentage of cases binding antibodies between VP without adenocarcinoma and VP with adenocarcinoma. However, B72.3 and anti-CEA stained VP without adenocarcinoma significantly more strongly than VP with adenocarcinoma (p < 0.05 and p < 0.025). VP without adenocarcinoma tended to bind anti-GCDFP-15 more strongly than VP with adenocarcinoma, but without statistical significance. Paget cells stained differently than the cells in their associated adenocarcinoma in two of six cases. In both of these cases, the Paget cells and adenocarcinoma were noncontiguous. In contrast, three of the remaining four cases contained adenocarcinoma contiguous with Paget cells. Immunocytochemistry with B72.3 seems to be as useful as anti-GCDFP-15 in identifying VP.