Hideki Hashimoto

A histochemical and immunohistochemical study of extra-ocular sebaceous carcinoma

A histochemical and immunohistochemical study of five cases of extra‐ocular sebaceous carcinoma was performed using formalin‐fixed and paraffin‐embedded tissue specimens. Histochemically, the clear cells of sebaceous carcinomas were negative with periodic acid‐Schiff and alcian blue staining. Immunohistochemically, the tumour cells of sebaceous carcinomas showed positive reactions for epithelial membrane antigen, human milk fat globules subclass 1, human milk fat globules subclass 2 and Leu M1, but did not express carcinoembryonic antigen, breast carcinoma associated antigen, S‐100 protein, gross cystic disease fluid protein‐15 or Dako M1. These histochemical and immunohistochemical findings were compared with those of other skin cancers which must be distinguished histopathologically from sebaceous carcinoma. We conclude that sebaceous carcinoma can be distinguished from eccrine porocarcinoma, malignant clear cell hidradenoma, extramammary Pagets disease, malignant trichilemmoma, squamous cell carcinoma and basal cell carcinoma by histochemical and immunohistochemical techniques using formalin‐fixed and paraffin‐embedded tissue specimens.

A case of ductal sweat gland carcinoma connected to syringocystadenoma papilliferum arising in nevus sebaceus

We report a case of a tumor arising in the preauricular region in a 50‐year‐old woman. The histopathological findings revealed it to be a ductal sweat gland carcinoma connected to a syringocystadenoma papilliferum (SCAP) arising in a nevus sebaceus. Mucinous stroma, considered to be deposition of hyaluronic acid, was also observed in the ductal carcinoma portion. The immunohistochemical and ultrastructural findings in the ductal carcinoma were compared with those in the SCAP. The proliferating cell nuclear antigen labeling index of the cells in the ductal carcinoma was higher than that of those in the SCAP. Both the ductal sweat gland carcinoma and SCAP showed findings compatible with the ductal segment of a sweat gland.

An Immunohistochemical Study of Sebaceous Carcinoma with Anti‐Keratin Monoclonal Antibodies: Comparison with Other Skin Cancers

Formalin‐fixed and paraffin‐embedded tissue specimens of six cases of extraocular sebaceous carcinoma were studied immunohistochemically with eight anti‐keratin monoclonal antibodies, 34βB4, 35βH11, Ks13.1, Ks19.1, PKK1, LP34, KL1 and AE1. The staining patterns of sebaceous carcinoma were compared with those of normal sebaceous glands and other skin cancers which should be distinguished from sebaceous carcinoma histopathologically. The other skin cancers compared were eccrine porocarcinoma, malignant clear cell hidradenoma, extramammary Pagets disease with underlying adenocarcinoma, malignant trichilemmoma, and squamous cell carcinoma. Most cases of sebaceous carcinoma were stained with 35βH11, Ks19.1, LP34, KL1 and AE1, while normal sebaceous glands were positive only with 35βH11, LP34, KL1 and AE1. By immunostaining, sebaceous carcinoma was distinguishable from extramammary Pagets disease with underlying adenocarcinoma, squamous cell carcinoma, malignant trichilemmoma, and eccrine porocarcinoma, but was not clearly distinguishable from malignant clear cell hidradenoma. These findings demonstrate that sebaceous carcinoma shows positive reactions with antibodies to simple epithelial keratin, probably as a result of neoplastic transformation, and that immunohistochemical examination using anti‐keratin monoclonal antibodies is useful in distinguishing sebaceous carcinoma from several other skin cancers.

Basal Cell Carcinoma within Vulvar Paget’s Disease

An 85-year-old Japanese woman had noticed erythema on her vulvar region 3 years before. The erythema gradually increased in size and followed erosion and ulceration with pigmentation on the edge of the erythema. A skin biopsy from the pigmented area showed large round cells with ample cytoplasm, which formed nests or glandular structures. In the dermis there was mass formation of basophilic cells and peripheral cells in a palisade arrangement. The tumor cells in the epidermis showed positive immunoreactivity for carcinoembryonic antigen; on the other hand, the dermal tumor was negative. We diagnosed that the tumor in the epidermis was vulvar Paget’s disease, and the dermal tumor was a solid type of basal cell carcinoma. We speculate that the vulvar Paget’s disease preceded and then the basal cell carcinoma developed in the area of Paget’s disease. This is the first report in which basal cell carcinoma in the area of Paget’s disease was documented.

Case of basal cell cancer in focus of vulva Paget disease.

We report a case of basal cell carcinoma (BCC) in the area of the genital Pagets disease. A 85-year-old woman noticed erythema on her vulvar region 3 years before, and the erythema gradually increased in size and followed erosion and ulcus on the erythema. Histologically, erythema revealed Pagets disease and the ulcus was the solid type of BCC.In the bordered area of Pagets disease and BCC, Paget cells infiltrated into the mass of BCC in the dermis, which were demonstrated with an immunopathological method using anti-CEA antibody.We speculated that the genital Pagets disease and BCC developed isolatedly in the different places nearly, after that, the BCC was surrounded by Pagets disese.