alcian-blue and Paget-Disease--Extramammary

Despite its occasional unavailability, alcian blue has long been the stain of choice for the pathognomonic mucin-secreting cells of extramammary Paget's disease. Zirconyl hematoxylin is a recently developed substitute for alcian blue, which is made from common laboratory materials.. We have stained sections from three different areas of the same case of extramammary Paget's disease with zirconyl hematoxylin, destained in 7% HCl in ethanol, restained with alcian blue at pH 2.5, destained in 2.5% trifluoroacetic acid in dichloromethane, and restained with zirconyl hematoxylin.. Each staining procedure stained the same cells.. Zirconyl hematoxylin is a useful alternative to alcian blue in the diagnosis of extramammary Paget's disease.

Topics: Aged; Alcian Blue; Hematoxylin; Humans; Male; Mucins; Paget Disease, Extramammary; Skin Neoplasms; Staining and Labeling; Zirconium

To identify a sensitive marker for extramammary Paget's disease and to identify histochemical and immunohistochemical features that suggest occult pelvic cancer in patients with extramammary Paget's disease, we retrieved all cases between 1983 and 1992 with a Standardized Nomenclature of Medicine code of extramammary Paget's disease in the Vanderbilt University Medical Center (Nashville, Tenn) surgical pathology archives. All were stained for alcian blue/dPAS (periodic acid-Schiff), mucicarmine, AE1/AE3, cytokeratin (CAM 5.2), cytokeratin (CK) 7, CK 20, carcinoembryonic antigen (CEA), orthokeratin, prostate-specific antigen, and S-100. Sixteen cases (2 men, 14 women) were retrieved. Two had pelvic malignancies: one rectal adenocarcinoma and one transitional carcinoma. Only CK7 marked all cases. Mucins were sensitive but focal, a potential problem in small biopsy specimens. The transitional tumor had a unique staining profile (CEA- and mucin-negative). CK20 strongly marked Paget cells associated with rectal cancer; its presence suggests a large bowel lesion but is not specific. No case expressed prostate-specific antigen; its presence in a man suggests prostatic carcinoma.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Alcian Blue; Antiporters; Apolipoproteins; Apolipoproteins D; Biomarkers; Biopsy; Carcinoembryonic Antigen; Carcinoma, Transitional Cell; Carmine; Carrier Proteins; Coloring Agents; Female; Glycoproteins; Histocytochemistry; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratins; Male; Membrane Proteins; Membrane Transport Proteins; Middle Aged; Mucins; Paget Disease, Extramammary; Pelvic Neoplasms; Prostate-Specific Antigen; Retrospective Studies; S100 Proteins

We report the first case, to our knowledge, of extramammary Paget's disease of the bronchial epithelium. The tumor displayed Paget's cells scattered within the bronchial epithelium in most of the lesion, but infiltrating into the bronchial submucosa and pulmonary parenchyma with microglandular and papillary patterns in some area. In addition to the histologic findings of coexistence with adenocarcinomatous components, in situ involvement into bronchial glands and ducts by Paget's cells was observed, suggesting that extramammary Paget's disease of the bronchial epithelium may be a variant of pulmonary adenocarcinoma, which is associated with bronchial glands.

Topics: Aged; Alcian Blue; Bronchi; Bronchial Neoplasms; Carcinoembryonic Antigen; Epithelium; Humans; Immunohistochemistry; Male; Mucins; Paget Disease, Extramammary

The cytoplasmic mucin in the Paget cells of extramammary Paget's disease was examined with a battery of histochemical techniques. The staining methods used were alcian blue, azure A and periodic acid-Schiff. In a further attempt to identify various polyanions, staining was carried out with alcian blue containing various concentrations of electrolyte. Methylation, saponification, borohydride reduction, acid hydrolysis, and digestion with diastase, sialidase, chondroitinase ABC, or nucleases were also employed. The results obtained suggest that the cytoplasmic mucin in the Paget cells is sialomucin without side-chain substituent.

Topics: Alcian Blue; Cytoplasm; Epidermis; Histocytochemistry; Humans; Mucins; Paget Disease, Extramammary; Periodic Acid-Schiff Reaction; Sialomucins; Skin Neoplasms