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- 左额叶占位
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There are both malignant glands (adenocarcinoma) and malignant spindled cell areas (suggestive of sarcoma) in the same frontal lobe tumor. This combination is very rarely seen in the brain. The possible differential diagnoses include WHO grade IV glioblastoma or gliosarcoma with aberrant glandular differentiation, carcinosarcoma (primary and metastatic), metastatic adenocarcinoma with sarcomatoid change, and metastatic high grade malignant peripheral nerve sheath tumor (MPNST) with epithelial elements. Immunohistochemistry is critical in further characterization of this malignancy. I recomment the following stains be done: GFAP, AE1, S100, TTF-1, Cam5.2. I look forward to any follow up of this very challenging and interesting case.
聞道有先後,術業有專攻
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zhang197510 离线
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zhang197510 离线
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| 以下是引用mjma在2009-4-5 7:56:00的发言： There are both malignant glands (adenocarcinoma) and malignant spindled cell areas (suggestive of sarcoma) in the same frontal lobe tumor. This combination is very rarely seen in the brain. The possible differential diagnoses include WHO grade IV glioblastoma or gliosarcoma with aberrant glandular differentiation, carcinosarcoma (primary and metastatic), metastatic adenocarcinoma with sarcomatoid change, and metastatic high grade malignant peripheral nerve sheath tumor (MPNST) with epithelial elements. Immunohistochemistry is critical in further characterization of this malignancy. I recomment the following stains be done: GFAP, AE1, S100, TTF-1, Cam5.2. I look forward to any follow up of this very challenging and interesting case. |
赞成mjma老师的观点，大致翻译如下：
在同一额叶肿瘤中有恶性腺样区（腺癌）和恶性梭形细胞区（提示肉瘤）。这种结构在大脑中是非常罕见的。可能的鉴别诊断包括WHOIV 的胶质母细胞瘤或胶质肉瘤伴异常腺癌分化（原发性和转移性） ，转移性腺癌伴有肉瘤样改变，高级别恶性外周神经鞘瘤（ MPNST ）与上皮要素。免疫组化标记这些恶性肿瘤是至关重要。标记如下： GFAP, AE1, S100, TTF-1, Cam5.2.。我期待着非常具有挑战性的和有趣的案例。
- 广州金域病理
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