能不能是内膜息肉突向宫颈管，腺体复杂性增生？

 能不能是内膜息肉突向宫颈管，腺体复杂性增生？

腺癌

invasive well differentiated adenocarcinoma. difficult to evaluate the deepth of invasive based on the photos.

For the orgin: Order CEA, vimentin, ER, p16.

For most cases of endometrial adecarcinoma: CEA-, vimentin+, ER+, p16-

For most cases of endocervical adenocarcinoma: CEA+, vimentin-, ER-, p16+.

IHC can help you in some cases, but often they can confuse you. In your comment you need to mention that clinical correlation with imaging is suggested for the origin of the tumor.

Based on the location of the tumor and patient's age it is more like an endocervical adenocarcinoma.

Do the patient have Pap test or HPV test before?

abin译：

浸润性高分化腺癌，根据图片难以判断浸润深度。

判断起源部位：做CEA, vimentin, ER, p16

大多数内膜腺癌：CEA-, vimentin+, ER+, p16-

大多数宫颈腺癌：CEA+, vimentin-, ER-, p16+

部分病例中IHC可能有帮助，但常常使人迷惑。备注中需要指出结合临床和影像学来判断肿瘤起源部位。

根据肿瘤部位和患者年龄，本例可能是宫颈腺癌。

患者做过宫颈细胞学检查和HPV检查吗？

CK and CK5/6, EMA ihc will not provide you useful information for this case.

CK20 and CDx2 positive for GI carcinoma (Ck7 negative)  and negative for gynecologic adenocarcinoma.

Ki67 < 5% is a liitle surprising finding. You can repeat ki67. Generally I did not do ki67 for this carcinoma.

Anyway, I feel positive that this is an adenocarcinoma case. The tumor may have focal villoglandular pattern.

Diagnosis line: Invasive well deffirentiated adenocarcinoma.

Comment:  Endocervical carcinoma is favorred based on the cytomorphologic features and the location. Clinical correlation with imaging result is suggested for the origin of the tumor (this sentense is to cover yourself for the origin).

Hope it can help.

abin译：

CK和CK5/6, EMA 对本例不会提供有用信息。

CK20和CDx2在胃肠道癌为阳性(Ck7阴性)，在妇科腺癌为阴性。

Ki67 < 5%有点意外，可以重复做一下Ki67。这种癌我一般不做Ki67。

总之，我觉得这例肯定是腺癌，可能有局灶区域为绒毛腺癌亚型。

诊断：浸润性高分化腺癌。

备注：根据细胞形态学特征和部位，倾向于宫颈腺癌。建议结合临床和影像学结果判断肿瘤起源部位。

希望对你有帮助。 

子宫颈腺癌（高分化）