Type of Preparation: Histology Magnification: High Clinical History: 64 year old postmenopausal woman with extensive Paget disease of vulva that appears to extend into the vagina Interpretation: Other Malignant Neoplasms: Paget disease Explanatory Notes: This tissue section of the primary tumor from the vulva shows an adenocarcinoma with cytologic features similar to those displayed in the vaginal smear. Note the presence of cytoplasmic vacuoles and the nesting of malignant cells to the left.