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本帖最后由 于 2009-01-03 02:54:00 编辑
Cellular specimen with cluster highly atypical cells showing pleomorphism, prominnat nuclei, and abundant cytoplasm with clear appearance in some cells.
Agree with above. It looks like adenocarcinoma. It can be endocercial or endometrial origins or metastatic tumor.
Tumor type can be clear cell carcinoma or other. Based on age and cytology, It can be endometrial endometrioid carcinoma. secretory variant. Remeber that I say "can" be....
Anyway in the Pap test it is good enough if you report adenocarcinoma or AGC favor neoplasma if you want to leave some space for you. For this case, it may provde you more information if you can prepare a cell block or do some IHC if you have a good cell block.
I mentioned here many times that Pap test is a screening test. We should keep this priciple in our mind when we evaluate Pap test.
Thank for the excellent case and photos. Waiting for your final histologic results.
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虽然中国改革的春风吹了多年，但是细胞病理的春天还没有到；不知道我们能否等到。幸运的是 每次看到赵老师的回帖都如沫春风，心情暖和许多。
这个病例个人观点如下：
1、细胞成团或簇并极性消失，成立体结构（3D）
2、核异性、大小不等；核仁明显
3、部分胞浆较为丰富，并呈透明样
4、细胞团明显不跟鳞状上皮在一个平面上（模糊的鳞状上皮），证明细胞团三维结构（颈管来源的腺细胞相对立体感没有那么强），倾向来源于内膜；当然也有可能象赵老师说的颈管或者转移。不过个人观点；不对之处，请各位老师指正。
如果要我签发报告我会诊断：AGC-FN ；如果这里讨论的话，我认为是来源内膜的透明细胞腺癌。等待中......
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I remember this case and come here to check the result. I like above discussion. We all have equal power and right to mention our oppinions here. We will not take any responsbility for what we said. For the true case we are not wrong if we report AGC. However we have to contact with patient's clinician to make sure the patient will have cervical and endometrial sampling. It is true that we must be very cautious to call carcinoma in Pap for these young patients.
Read photos again. generally speaking , clear cell carcinomas have more ugly cytology, but these cells are relative bland even though we can appreciate the pleomorphism of cells. So endometrioid carcinoma???
Thank for the interesting case. We are waiting for your surgical results.
Do you have residule fluid? You can ask Lab to make a cell block if you have. It may be helpful. My feeling is there are many clusters of cells in the fluid.
