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啊呀,好惭愧,我没看清病史,以为是卵巢病变了
盆腔活检,上皮样恶性肿瘤,有乳头结构和砂粒体。主要考虑间皮瘤(上皮样型/蜕膜样型)、腺癌(腹膜原发或转移性)、GIST、蜕膜变。
最近一项研究认为,calretinin和thrombomodulin作为腹膜间皮瘤的阳性标记物,Ber-EP4, MOC-31, CA19-9, ER作为腹膜间皮瘤的阴性标记物,对鉴别腹膜间皮瘤和浆液性腺癌具有相当高的特异性和敏感性。
华夏病理/粉蓝医疗
为基层医院病理科提供全面解决方案,
努力让人人享有便捷准确可靠的病理诊断服务。
alading1999 离线
IHC results:
F1 Calretinin
F2 CK5/6
F3 Mesothelin
F4. BerEP4
Others:
WT1 +
CK7+
MOC-31 -
ER-
Abin summaried well. Generally at least two mesothlial markers and two epithelial markers are needed for the differential dx.
Lesson: Always consider the possible differential dx and decide to order the IHC stains.
Final dx: mesothelioma
When we have a case we must have differential diagnosis. In other words we must think many different possible diagnoses, then order the necessary IHC and rule out others.
You cannot just have a possible dx and order one stain. We as pathologists should consider and analyse questions more widely.
以下是引用cqzhao在2008-11-23 22:20:00的发言:
When we have a case we must have differential diagnosis. In other words we must think many different possible diagnoses, then order the necessary IHC and rule out others. You cannot just have a possible dx and order one stain. We as pathologists should consider and analyse questions more widely. |