FLOW CYTOMETRIC DNA ANALYSIS OF EXTRAMAMMARY PAGETS-DISEASE OF THE VULVA

Vulvar extramammary Paget's disease (EMPD) is an uncommon disease enti ty that occurs predominantly in postmenopausal white women. The clinic al behavior of this neoplasm is extremely variable, reflecting the var ious histological patterns that have been reported with this lesion, F low cytometry has been used as a method of obtaining prognostic inform ation about a number of gynecological neoplasms, yet to date there hav e been no flow cytometric studies performed on this unusual neoplasm. We performed flow cytometric analysis of 14 cases of paraffin-embedded vulvar EMPD in patients ranging from 45 to 86 years of age. We correl ated histological features and clinical recurrence risk with DNA analy sis. Although we were unable to show a statistically significant corre lation between DNA ploidy or S-phase and time to recurrence, we did sh ow a statistically significant correlation between DNA ploidy and hist ological features. Aneuploidy appears to be associated with in situ sw eat gland adenocarcinoma, invasive carcinoma, and lymphatic invasion. These results suggest that Paget's cells with aneuploid DNA stem lines may be associated with the potential for aggressive biologic behavior .