Ovarian melanoma (cqz 4) - 华夏病理网论坛

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楼主发表于 2009-02-07 01:23|举报|关注(0)
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women/about 40 years with a left ovarian mass 13 cm.

Procedure: BSO, hysterectomy, lymph node resection, omentectomy, appendectomy.

Cytomorphology of the tumor is as above photos.

Your interpretations.

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本帖最后由于 2009-02-25 03:02:00 编辑

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1 楼发表于2009-02-25 02:53:00举报|引用
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本帖最后由于 2009-02-25 03:01:00 编辑

Stain for s100, HMB 45, Malan-A

This is an easy case. I showed here because it is rare. Clinically the primary lesion have not be found yet. We still think it is a metastatic lesion. Sometimes we see the metastatic lesions, but cannot find the primary lesions.

Lesson: For unusual cases, always have the differential diagnoses, and then do some IHC to rule out or rule in.

Thank you for reading the case.

cz

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2 楼发表于2009-02-21 05:27:00举报|引用
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以下是引用漫游人在2009-2-20 22:08:00的发言：

Based on H&E, I would consider following differentials
1. small cell carcinoma, hypercalcemic type. However, it is unlikely the diagnosis since epithelial markers are all negative.
2. PNET. CD99 should be positive in most cases. I noticed the current case is negative.
3. endometrioid stromal sarcoma. There are no characteristic vessels in this case as seen in typical stromal sarcoma of endometrium.
4. melanoma. it can look like anything. IHC can easily rule in or out it.
5. lymphoblastic lymphoma/leukemia. Mitosis is not high, IHC results do not support.
6. rhabdomyosarcoma. Although there is no idenitifiable rhadomyoblast and no IHC result, I still think this should be the favoured diagnosis.
Thank you for the many excellent cases and great effort.

Thank for your consideration for this case. This is the way we should use for analysis of these kinds of the cases. Pathologists cannot guess the diagnosis.

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3 楼发表于2009-02-20 22:08:00举报|引用
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Based on H&E, I would consider following differentials
1. small cell carcinoma, hypercalcemic type. However, it is unlikely the diagnosis since epithelial markers are all negative.
2. PNET. CD99 should be positive in most cases. I noticed the current case is negative.
3. endometrioid stromal sarcoma. There are no characteristic vessels in this case as seen in typical stromal sarcoma of endometrium.
4. melanoma. it can look like anything. IHC can easily rule in or out it.
5. lymphoblastic lymphoma/leukemia. Mitosis is not high, IHC results do not support.
6. rhabdomyosarcoma. Although there is no idenitifiable rhadomyoblast and no IHC result, I still think this should be the favoured diagnosis.
Thank you for the many excellent cases and great effort.

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4 楼发表于2009-02-17 10:45:00举报|引用
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No one can make dx by H&E only for this kind of cases. Should have differential dx first, then order the IHC. Rule in or out based on the IHC results.