Pre-Paget cells express a Paget cell marker before losing a keratinocyte marker.

Extramammary Paget's disease (EMPD) is a cancer of the anogenital epithelium. Its origin has been variously attributed to keratinocytes or to Toker cells. Slides of 3 advanced cases of EMPD were incubated with trypsin to retrieve antigens. The slides were then stained with rabbit polyclonal anti-carcinoembryonic antigen to mark Paget cells and mouse monoclonal anti-cytokeratin 10 to mark keratinocytes. Several cells in each case stained with both the Paget cell marker and the keratinocyte marker. The presence of cells with both markers shows that Paget cells originate from keratinocytes. The presence of pre-Paget cells in advanced cases of EMPD shows that Paget cells are continuously recruited from keratinocytes.

Pre-Paget cells: Evidence of keratinocyte origin of extramammary Paget's disease.

Extramammary Paget's disease (EMPD) is a carcinoma of the genital, perianal, and, rarely, axillary skin. The malignant Paget cells migrate extensively in the epidermis before invading the underlying dermis. Toker cells and keratinocytes have both been suggested as the cells of origin of EMPD. Paraffin sections of eight cases of EMPD were immunohistochemically stained for carcinoembryonic antigen, a known marker for Paget cells. The presence of carcinoembryonic antigen in some keratinocytes in all of the observed cases of EMPD suggests that EMPD originates from keratinocytes. Thus, keratinocytes containing carcinoembryonic antigen are pre-Paget cells.

Use of an improved zirconyl hematoxylin stain in the diagnosis of Barrett's esophagus.

Barrett's esophagus is a precancerous condition characterized by replacement of the normal stratified squamous epithelium by a simple columnar epithelium with goblet cells that secrete an acidic mucin. As originally formulated, fresh solutions of zirconyl hematoxylin stain goblet cells poorly. An improved formula, quintupling the amount of oxidant, yields zirconyl hematoxylin solutions that stain goblet cells darkly even when fresh. The improved zirconyl hematoxylin can be used in place of alcian blue in the diagnosis of Barrett's esophagus. The ingredients of zirconyl hematoxylin are always readily available and are generally recognized as safe.

Zirconyl hematoxylin vs. alcian blue staining in a case of extramammary Paget's disease.

BACKGROUND: 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. METHODS: 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. RESULTS: Each staining procedure stained the same cells. CONCLUSIONS: Zirconyl hematoxylin is a useful alternative to alcian blue in the diagnosis of extramammary Paget's disease.