SCRAPE CYTOLOGY OF PEMPHIGUS-VULGARIS OF THE NIPPLE, A MIMICKER OF PAGETS-DISEASE

A case of histologically and immunocytochemical confirmed pemphigus vu lgaris of the nipple examined by scrape cytology is reported The scrap e cytology showed isolated and somewhat loosely clustered cells with b asophilic cytoplasm and vesicular hyperchromatic nuclei dysplaying pro minent nucleoli, suggesting Paget's disease of the nipple. However; hi stological examination of the resected tissue together with the direct immunofluorescence technique for demonstration of in vivo-bound immun oglobulin to epithelium confirmed the diagnosis of pemphigus vulgaris. The use of an immunoperoxidase stain for IgG on the Papaniolaou-desta ined smear also gave a positive reaction on the cell membranes and pro vided a precise cellular diagnosis of the lesions. Cytodiagnostic pitf alls of these rare breast lesions are discussed, as well as the diagno stic value of immunocytochemistry. (C) 1997 Wiley-Liss, Inc.