Detection of pagetoid urothelial intraepithelial neoplasia extending to the vagina by cervical screening cytology: a case report with renewed immunochemical summary

Table 1 Clinicopathologic and laboratory differences between Paget-like neoplasms and mimics of the lower genital tract

	Extramammary/vulvar Paget disease	Pagetoid urothelial carcinoma	Pagetoid colorectal carcinoma	High-risk HPV-associated neoplasm
History	Not characterized	Prior urinary tract neoplasm	Prior anorectal neoplasm	Atypical squamous/glandular cells in screening cytology
Cell morphology	Paget cells characterized by abundant pale cytoplasm and prominent nucleoli with rare mitoses	Highly stratified/disarranged or pleomorphic/anaplastic cells with mitotic activity	Colonic type cells with intracytoplasmic mucin and goblet cells	Cells indicating high-grade squamous/glandular intraepithelial lesion or their invasive forms
Immunochemical markers
Typically positive	CK7, CAM5.2, GCDFP15, CEA, CA125, HER2/neu, androgen receptor	CKs 7 and 20 (co-expression), p63, HMWCK, uroplakins II and III, thrombomodulin	CK20, CEA, CDX2, MUC2	p40, p63, HMWCK (squamous neoplasm); CK7, CEA (glandular neoplasm)
Typically negative	CK20, ER, PgR	GCDFP15, CEA	CK7, GCDFP15	CK20, GCDFP15
p16/Ki-67 double labeling	Unknown	Usually positiveRef #9	Unknown	Positive
GATA3	PositiveRef #10	Usually positiveRef #11	NegativeRef #11	Usually negative, but occasionally weakly positiveRef #12
HPV test	Negative	Negative	Negative	High-risk genotypes detected

HPV human papillomavirus, CK cytokeratin, ER estrogen receptor, PgR progesterone receptor, GCDFP15 gross cystic disease fluid protein 15, CEA carcinoembryonic antigen, HER2 human epidermal growth factor receptor 2, HMWCK high-molecular-weight cytokeratin, MUC2 mucin 2, GATA3 GATA binding protein 3, Ref reference article

ISSN: 1746-1596