Toker Cell Hyperplasia
Christine J. Ko, MD
Key Facts
Terminology
Increase in number of Toker cells in epidermis
Absence of underlying ductal carcinoma
Mimics Paget disease of the nipple
Clinical Issues
Very rare
Incidental finding
Nipple normal clinically/grossly
Microscopic Pathology
Round to slightly oval nuclei
Abundant cytoplasm that is slightly pale to clear
No pleomorphism
CK7 positive
Top Differential Diagnoses
Paget disease of the nipple
Pagetoid dyskeratosis
Clear cell papulosis
 Toker cell hyperplasia is a rare histopathologic finding. Toker cells, a normal component of the nipple epithelium, are increased in number and may mimic Paget disease of the nipple. |
 In Toker cell hyperplasia, Toker cells are evident by light microscopy, and they are also highlighted by CK7 staining. The bland cells are scattered in the basal and suprabasal layers. |
TERMINOLOGY
Definitions
Increase in number of Toker cells in epidermis
Absence of underlying ductal carcinoma
Mimics Paget disease of the nipple
Awareness important to avoid overdiagnosis of Paget disease
CLINICAL ISSUES
Epidemiology
Incidence
Toker cells present by light microscopy in ˜ 10% of normal nipples
Toker cells also described in
Vulva
Accessory nipples
Along milk line of epidermis
Overlying nipple duct adenoma/florid papillomatosis of the nipple
Toker cell hyperplasia
Rare
Described in 2 cases out of 340 in Toker’s original series
Increase in number of Toker cells, mimicking Paget disease of the nipple
Absence of underlying ductal carcinoma
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