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- an easy case for you-Pap test (cqz 3)
我们的报告和月新老师的相似，请赵老师指导：
根据此例所给图像（我们要描述大体观察，然后病理诊断）
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大体观察：（根据取材情况描述）子宫的大小，表面情况，宫腔深，宫内膜厚度及肿块的大小4x3x 病理诊断： 1、子宫浆液性乳头状腺癌（Ⅲa期G3)，癌浸润子宫肌的75%.宫颈未见癌生长， 2、 右卵巢查见转移性肿瘤，大小为 3、 大网膜查见一个转移性腺癌结节， 4、 （盆腔冲洗液细胞涂片）查见腺癌细胞团， 5、 左卵巢及双侧卵管，子宫颈未见肿瘤生长， 6、 送检标本中淋巴结未见癌转移（0/?）。 IHC： P53等 |
- 广州金域病理
Both of your reports are very good.
Only this term 子宫内膜中分化浆液性乳头状腺癌:
Uterine serous and clear cell carcinoma are type 2 tumor. Both are high grade carcinoma. So we do not need to mention high grade serous or clear cell carcinoma. Of cause we will not say well or moderately differentiated serous or clear cell carcinoma.
Thank you two for working on this case.
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本帖最后由 于 2008-12-28 20:15:00 编辑
译上楼： Both of your reports are very good. 二位的病理报告签发的非常好。Only this term 子宫内膜中分化浆液性乳头状腺癌:
但是这个名称“子宫内膜中分化浆液性乳头状腺癌”不太合理。
Uterine serous and clear cell carcinoma are type 2 tumor.子宫浆液性了透明细胞性癌都是II型癌。 Both are high grade carcinoma. 两个都是高级别肿瘤。So we do not need to mention high grade serous or clear cell carcinoma. 因此我们不需要分级（即：浆液性癌或透明细胞癌都是高级别癌）。Of cause we will not say well or moderately differentiated serous or clear cellcarcinoma. 当然就不能说高分化或中分化浆液或透明细胞癌。Thank you two for working on this case.谢谢二位。
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本帖最后由 于 2008-12-24 12:02:00 编辑
| 以下是引用月新在2008-12-24 11:14:00的发言： 查见这样一个宫颈异形上皮细胞团，引起这么长时间的讨论，自己每发一次帖，受赵老师点评一次，感觉自己进步一次，收获很大，多年养成的小的毛病全都暴露无遗，我每次发贴都有许多暇疵，虽然干病理工作多年，工作不慎密，思维不活跃，报告不规范。这些都需要纠正。再次感谢赵老师。 |
Thank you for your good words.
You must learn Chairman Mao's words very well. You are a person with self-criticism. Kiding.
Everyone makes some mistakes, even the world-famous professors.
In the US many people always feel they are the best in the world. In fact they should learn from Chinese.
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It will be Christmas Eve tomorrow. I do some summaries about this Pap case
- Some of the clusters demonstrate a papillary morphology with an irregular outline.
- The cell block preparation demonstrates fibrovascular cores lined by stratified malignant cells with scant cytoplasm, enlarged hyperchromatic nuclei, prominent nucleoli with scattered mitotic figures on hematoxylin and eosin staining.
Cytomorphology of the case
1. Clusters of large malignant cells with scant cytoplasm, marked variation in nuclei size, nuclear hyperchromasia with coarse chromatin, irregular nuclear membranes and prominent nucleoli.
Disease Fact Sheet about uterine serous carcinoma
1. Aggressive high grade endometrial adenocarcinoma first described in 1982.
2.
Associated with p53 mutations.
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Associated with endometrial polyps and commonly polypoid.
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Not associated with increased estrogen & endometrial hyperplasia.5. 2/3 have malignant pap smears since buds and tufts break off.
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25% have primary endocervical involvement.
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Drop metastases to the vagina is common.
8.
Transtubal spread common, creating ovarian implants and omental tumor nodules.Cytomorphology of Papillary Serous Adenocarcinoma (Pap)
n Malignant cells are isolated or arranged in clusters.
n Nuclei are enlarged and demonstrate variation in size.
n There is nuclear hyperchromasia with coarsely textured chromatin and prominent nucleoli.
n Cytoplasm may be scant but is often abundantly vacuolated.
n Psammoma bodies may be present.
Cytomorphology of Papillary Serous Adenocarcinoma
n Differential diagnosis:
1. Endometrioid carcinoma: difficult in Pap test
2. Reactive benign endocervical cells: this is the money for pathologists
3 Reactive mesothelial cells (in pelvic washing)
n clusters, flat sheets or single cells
n Cytoplasm is dense & distinct
n Multinucleation
n Nuclei chromatin vary from bland to hyperchromatic
n Nucleoli-small to prominent
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本帖最后由 于 2008-12-28 20:17:00 编辑
| 以下是引用cqzhao在2008-12-24 12:13:00的发言：
Cytomorphology of Papillary Serous Adenocarcinoma (Pap) n Malignant cells are isolated or arranged in clusters.
n Nuclei are enlarged and demonstrate variation in size.
n There is nuclear hyperchromasia with coarsely textured chromatin and prominent nucleoli.
n Cytoplasm may be scant but is often abundantly vacuolated.
n Psammoma bodies may be present. |
大致翻译如下：
乳头状浆液性腺癌细胞形态学（巴氏涂片）
恶性细胞单个散在或成簇排列。
细胞核增大，核大小变化较大。
核深染、染色质粗糙、明显的核仁。
细胞质可很少，但常含大量空泡。
可出现沙砾体。
- 广州金域病理
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本帖最后由 于 2008-12-28 20:20:00 编辑
| 以下是引用cqzhao在2008-12-24 12:20:00的发言：
Cytomorphology of Papillary Serous Adenocarcinoma n Differential diagnosis: 1. Endometrioid carcinoma: difficult in Pap test 2. Reactive benign endocervical cells: this is the money for pathologists 3 Reactive mesothelial cells (in pelvic washing) n clusters, flat sheets or single cells n Cytoplasm is dense & distinct n Multinucleation n Nuclei chromatin vary from bland to hyperchromatic n Nucleoli-small to prominent |
大致翻译如下：
浆液性乳头状腺癌细胞形态学
鉴别诊断：
1 、子宫内膜样癌：宫颈细胞学诊断很难。
2 、反应性的良性子宫颈细胞：对于病理学家是财富(money)?
3、反应性的间皮细胞（腹水中）
成群、平铺或单个的细胞
细胞质浓密和独特
多核
核染色质从淡染到深染各不相同
核仁：小到明显。
- 广州金域病理
