The images show the characteristic large cells with clear cytoplasm in the epidermis. The H&E slide is not definitive; the clear cells may represent:

• Benign Toker cell hyperplasia.
• Malignant melanoma.
• Bowen's disease.

The definitive diagnosis is determined with immunohistochemical stains (S-100 -ve and HMB-45 -ve (both typically +ve in melanoma), CK7 +ve, CEA +ve (-ve in Bowen's disease, -ve in Toker cells).

The histologic appearance of Paget's disease of the breast is identical to extramammary Paget's disease, i.e. it is not possible to say this is extramammary from the image alone.

• 
  Low mag.
• 
  Intermed mag.
• 
  High mag.
• 
  Very high mag.
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  Very high mag.