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- 0811344卵巢肿瘤
The photos show fragmented tumor tissue, which makes the dx difficult.
Carcinoma, sarcoma, sex cord-stromaal tumr
Do some IHC first:
Pan CK, CK7, CK20
Vimentin for sarcoma
Inhibin, calretinin for sex cord stromal tumor
WT1, P53 for serous carcinoma
ER, endometroid ca
Transitional cell ca, poorly differential ca
Anyway you have to do some IHC, and then think about.
Hope to see your follow up result.
| 以下是引用cqzhao在2008-12-6 11:17:00的发言：
The photos show fragmented tumor tissue, which makes the dx difficult. Carcinoma, sarcoma, sex cord-stromaal tumr Do some IHC first: Pan CK, CK7, CK20 Vimentin for sarcoma Inhibin, calretinin for sex cord stromal tumor WT1, P53 for serous carcinoma ER, endometroid ca Transitional cell ca, poorly differential ca Anyway you have to do some IHC, and then think about. Hope to see your follow up result. |
译文：照片显示的是碎片状的肿瘤组织，使得诊断比较困难。
癌、肉瘤、性索-间质肿瘤
首先要做CKpan、CK7、CK20标记，其次要做vimentin是否为肉瘤、inhibin、calretinin诊断性索间质肿瘤，WT1和p53诊断浆液性癌，ER诊断子宫内膜样癌，还有移行细胞癌、差分化癌。无论如何你要做免疫标记，然后才考虑。
希望能看到你的最后结果。
镜下组织较破碎，未见囊性肿瘤的囊壁结构。根据临床手术和病理所见，推测可能有以下两种情况：
1.如图片中为囊性肿瘤的一部分，而其他部分是单纯的囊壁结构，根据图片肿瘤细胞呈梭形， 瘤细胞有异型和核分裂，我考虑为浆液性或粘液性囊性肿瘤伴肉瘤样附壁结节；
2.如果肿瘤所有囊壁均为图片提供的结构，则可能为实性肿瘤伴囊性变，那应归为卵巢梭形细胞肿瘤病变。结合图片，我认为恶性肿瘤。对于卵巢恶性梭形细胞病变，有以下一些：性索间质肿瘤、平滑肌源性肿瘤、GIST、子宫内膜样癌伴梭形细胞成分、癌肉瘤或腺肉瘤、间皮瘤、恶性黑色素瘤和可能Wolffian管来源的女性附件肿瘤等。需要做免疫标记。
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本帖最后由 于 2008-12-12 14:55:00 编辑
| 以下是引用njwbhuang在2008-12-6 23:08:00的发言：
镜下组织较破碎，未见囊性肿瘤的囊壁结构。根据临床手术和病理所见，推测可能有以下两种情况： 1.如图片中为囊性肿瘤的一部分，而其他部分是单纯的囊壁结构，根据图片肿瘤细胞呈梭形， 瘤细胞有异型和核分裂，我考虑为浆液性或粘液性囊性肿瘤伴肉瘤样附壁结节； 2.如果肿瘤所有囊壁均为图片提供的结构，则可能为实性肿瘤伴囊性变，那应归为卵巢梭形细胞肿瘤病变。结合图片，我认为恶性肿瘤。对于卵巢恶性梭形细胞病变，有以下一些：性索间质肿瘤、平滑肌源性肿瘤、GIST、子宫内膜样癌伴梭形细胞成分、癌肉瘤或腺肉瘤、间皮瘤、恶性黑色素瘤和可能Wolffian管来源的女性附件肿瘤等。需要做免疫标记。
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分析到位。
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yuanchuantao 离线
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Among 5 types of ovarain epithelial neoplasms (serous, mucinous, endometrioid, clear cell and transitional cell), transitional cell carcinoma is not a bad guess. Diagnosis of ovarian TCC is pretty much relying on H&E morphology since there is no distinctive immunoprofies for ovarian TCC. However, the cytology is on the blend side in this case. Therefore, you may want to apply some immunostains to rule out sex cord tumors, carcinoid tumor and granulosa cell tumor.
You may want to have a better sampling for this case. I would also like to see more low power photos to see if it has ribbon-like growth pattern since low power picture can be very useful in differentiate TCC from papillary serous carcinoma. Also a little suggestion here, please do not use "Auto color" function from your photo editting software. it tends to loss the original color.
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